The Walworth Clinic, Southwark: ‘the Health of the People is the Highest Law’

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1930s, Southwark

‘Salus populi suprema est lex’. Cicero said it fourteen centuries earlier but Southwark Borough Council translated the phrase into English and bricks and mortar and placed it proudly above the entrance of the new Walworth Clinic opened in 1937.

The state, by then, had come to recognise some responsibility for the welfare of its citizens but this had been a tortuous and piecemeal process.  Regularly employed male workers might enjoy National Insurance or trade union and Friendly Society benefits.  The poorest were stigmatised still by their dependence on charity or the Poor Law and its vestiges.

In 1929 the Local Government Act turned over remaining Poor Law services to the counties and boroughs.  It was an opportunity for progressive councils to build on functions already acquired – in maternal and infant welfare and tuberculosis care and prevention – to develop comprehensive healthcare programmes for their population. In this way, they would prefigure the National Health Service created in 1948.

Local health centres – such as those already examined in Finsbury, Bermondsey and Woolwich – were an important element of this programme and would be models for primary healthcare in the new post-1948 service. 

Walworth in 1946 from http://www.britainfromabove.org.uk. Image EAW000645 © English Heritage

Southwark first came under Labour control in 1919 when the Party swept to victory in local elections across the country. In the same year, the Maternity and Child Welfare Act was passed.  The new Council took up the cause, investing, for example, in a municipal store to supply cost-price or free milk and medicines to expectant mothers.

Southwark Labour lost power in 1922. The Municipal Reformers – antagonistic towards anything that smacked of ‘municipal socialism’ and jealous guardians of the ratepayer’s purse – scaled down these efforts.

But 1934 saw Labour back in power and committed to further reform. A Public Health and Sanitary Committee was established, a ‘complete investigation of the public health problems of the borough’ set under way.  The Medical Office of Health, William Stott, was asked to specify the premises he needed to deliver local health services.

The Centre illustrated in 1937 with white stone parapets now disappeared © Southwark Local History Library and Archive

The result? Three years later, Southwark was ‘the first borough to have the whole of its health services in one building’ – a building which Councillor Gillian, the chair of the Committee, claimed ‘beats Harley Street’.(1)

The Council took the view, Gillian stated,  that :(2)

Cllr AJ Gillian

when the health of the people, and particularly the poorer classes of the population, is involved, only the best equipment and the most modern scientific devices would suffice.

The Walworth Clinic, built at a cost of £50,000, would be  in form and content a practical fulfilment of these principles.

The building itself, designed by Percy Smart, still has a strong presence on Walworth Road.  Architecturally, according to English Heritage who listed it Grade II in 2010, it’s notable for its ‘strong massing, brick elevations, and jazzy details…a hybrid of Modern Movement and Art Deco styles’.

The Lancet was complimentary: (4)

The borough council have wisely decided that the building shall have a pleasing appearance and by the brightness of its interior give a cheery welcome, so that the inhabitants may be encouraged to make full use of an institution devoted to the improvement of their health.

Statuary group as shown in the opening programme © Southwark Local History Library and Archive

Easily missed but powerful when viewed is the statuary group, by an unknown sculptor, at the top of the building. A woman and three children of varying ages, the figures are both allegorical (the woman is holding the healing rod of the Greek god Aesculapius) and recognisably ‘real’ with their modern hairstyles and the child’s doll. These were: (3)

designed to symbolise the functions of the new building with relation to family health – motherhood, various stages of childhood and the spirit of healing.

But if these externals were important – and they were for the combination of dignity and accessibility they offered to the priority of the people’s health – you can feel from the contemporary descriptions that it’s the facilities and equipment that really excited the professionals.

The Centre today

The side and rear of the building from Larcom Street

Southwark, in the best form of one-upmanship, listed its innovations – the ‘first maternity department in the country to have an illuminated colposcope’ (you can look it up), the first to install an X-Ray department, and the only borough to have a ‘complete full-time chemical and bacteriological laboratory’.  The building was air-conditioned too.

Artificial Sunlight and Radiant Heat Clinic © Southwark Local History Library and Archive

X-Ray Clinic © Southwark Local History Library and Archive

The Centre, the Council stated, marked ‘a further great step’ towards its goal – ‘the betterment of the health of the people of Southwark generally’.

That meant administrative offices and qualified personnel (including a ‘Lady Sanitary Inspector’ and ‘Lady Assistant Medical Officers’) too as well as the vital front-line services – a dispensary, a TB clinic and solarium, a dental clinic, regular maternity and child welfare clinics, of course, and a weekly clinic for women over 45 ‘subject to illness and disease peculiar to this age period’.

The basement contained a ‘Tuberculosis Handicraft Centre’ where unemployed TB sufferers could learn craft skills which might lead to employment or might, at least, provide a useful hobby.

Rheumatic clinics and breast-feeding clinics were planned for the future.

And the Centre was only part of a programme which the Council understood quite clearly as a comprehensive assault on poverty and its causes. When rats overran one part of Southwark, the Council built a new sewerage system, costing £70,000. Opened just three months after the health centre, it too aimed to raise ‘the health of the people’.

Whereas Southwark once had the highest death rate in London and one sixth of its houses had been declared unfit for human habitation, Councillor Gillian could assert in 1937 that: (5)

This two-fold evil was being resolutely dealt with …Slums were being cleared, overcrowding was being overcome by new housing plans and Southwark was now one of the healthiest boroughs of London.

Over seventy-years later, the Elephant and Castle down the road is being redeveloped again and the centre itself looks slightly forlorn. There’s still an NHS clinic on the Larcom Street side but, as the signs in the contemporary photograph indicate, the building is to be let as office space. It’s a sad decline for a building which started with such bold and practical ideals.

In fact, the Walworth Clinic was a model superseded by the NHS a little over ten years after its opening.  There were plans for local health centres – based on these London examples – in the original NHS blueprint but the 162 envisaged, serving population centres of 20,000, were implemented only sporadically .

There was a loss here of democratic initiative, impetus and control that might have served the NHS well.  No-one would wish a return to the haphazard localism of the pre-NHS era but reforming and ambitious councils represented and practised the ideal of a community’s responsibility to safeguard and support its sick and vulnerable. The Walworth Clinic reminds us of that.

Sources

(1) Quoted in the Daily Telegraph, 17 September 1937 and South London Press, 1 October 1937, respectively

(2) Programme of the Opening of the New Health Services Department by the Worshipful Mayor of Southwark (Cllr CJ Mills) on Saturday September 25th 1937

(3) Programme of the Opening of the New Health Services Department…

(4) The Lancet , October 2 1937

(5) The Times, September 27 1937

Other detail and analysis comes from Esyllt Jones, ‘Nothing Too Good for the People: Local Labour and London’s Interwar Health Centre Movement, Social History of Medicine, vol 25, no.1 , February 2012.

The historic images come from the superb collection of photographs held by the Southwark Local History Library and Archive and are used with their permission.

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Healthcare in Bermondsey: reaching for the ‘New Jerusalem’

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1920s, 1930s, Bermondsey

1937 Sculpture by Allan Howes on Grange Road Health Centre

Before the advent of a national health service in 1948, progressive local councils took their responsibilities towards the health of their people seriously. Nowhere was this more so than in the crowded inner-London borough of Bermondsey, not least because the leading figure of the local Labour movement was a local GP, the redoubtable Dr Alfred Salter.

We’ve seen this already in Bermondsey’s health propaganda and in its beautification schemes.  Housing was, of course, another vital aspect of what can be truly called – in modern jargon – an holistic programme.  The borough’s commitment to a ‘cottage home for every family’, exemplified in the Wilson Grove Estate, was intended to promote healthy living in every sense.

Today’s post looks at the more direct expression of the council’s healthcare agenda and, in particular, at what remains one of its most striking and heart-warming elements – its campaign against the local scourge of tuberculosis.

Such work depended not only on an idealistic and reforming council – Labour took control of Bermondsey in 1922 and secured its majority in succeeding elections – but on dedicated healthcare professionals. When Dr King Brown was appointed Medical Officer of Health in 1901, he joined a team comprising a part-time medical officer, a chief sanitary inspector, eight district inspectors, and three clerks.

Bermondsey’s Health Department staff, 1930s

When he retired twenty-six years later, his department was made up of five full-time medical officers, a full-time dental surgeon and part-time assistant, an inspectorate of fourteen, a staff of eight health visitors, nurses and other assistants for dispensary and dental work, plus clerks.(1)

Such elaborate healthcare needed premises.  Following the 1918 Maternity and Child Welfare Act the Council opened its first mother and child clinic in 1920.  Four others followed in rapid order.

Infant welfare in Bermondsey, 1930s

Public baths and washhouses (for laundry) had been a feature of local council provision since the mid-nineteenth century but even in 1925 it was determined that only 150 houses in Bermondsey had fitted bathrooms.  Typically the borough determined to provide the best public baths of their kind.

Bermondsey’s Municipal Baths, Grange Road

The Grange Road baths opened in 1927, with 1st and 2nd class swimming baths, 126 private baths, four baths for babies and Turkish and Russian vapour baths. A contemporary newspaper thundered against this ‘£150,000 Palace of Baths’ and its ‘Marble Halls and Stained Glass Windows and Turkish Baths That Few Can Afford’. They would, it claimed, have satisfied ‘even the most luxury-loving Roman patrician’.

He probably wouldn’t have used one of the eight rotary washing machines, four hydro-extractors or forty drying horses provided to do his own washing, however. Salter pointed out that the legislation required first and second-class provision and said he would have been happy to provide the baths free of charge had it been possible.  Later, local pensioners and the unemployed were granted free use. (2)

Projected health centre, 1928

The Council’s healthcare showpiece would be the new health centre promoted by King Brown’s successor, Donald Connan. The original £96,000 plans were scuppered by the refusal of loan support by the Ministry of Health and London County Council but the finished building – built at a cost of £44,125 and supported by the new Labour-controlled LCC after 1934 – remains impressive.

Grange Road Health Centre, 1936

Designed by Borough Architect, Henry Tansley, the building opened in 1936 and contained infant welfare and ante-natal clinics, rooms for radiotherapy and diathermy (heat treatment using high-frequency electrical current), a foot clinic and a solarium and dispensary for sufferers of TB.

There was nothing glamorous about the treatment of ‘corns, callouses, bunions, in-growing and thickened toenails and warts’ but it was a vital service for a local workforce frequently on its feet all day and Bermondsey was the first council to provide it.  The first clinic opened in 1930.  Five years later, Bermondsey’s mayor, Cllr George Loveland, could look back sardonically on the amusement it caused, knowing that ‘whatever new social service Bermondsey started it was invariably successful and often copied elsewhere’. (3)

There was nothing funny about TB though. In the 1920s, 5500 local people had TB, there were around 400 new cases each year and 200 to 250 died annually from the disease.  Almost half of those afflicted shared a bed and the council’s first endeavour was to provide backyard shelters for sufferers to sleep in.

Leysin

The council was determined to take a more proactive stance, however, and from 1924 the Council annually reserved six places in Dr Auguste Rollier’s pioneering Sun Clinic at Leysin in the Swiss Alps.  Of Bermondsey’s first six patients, five went on to make a full recovery and many local people benefited from the treatment over the years.

Light treatment at the Grange Road Health Centre

But King Brown knew a larger-scale and more local service was needed also. In 1926, Bermondsey took over three houses and gardens in Grange Road as a Light Treatment Centre, equipped with eight large mercury vapour lamps, two carbon arc lams, one water-cooled Kromayer lamp and two radiant heat lamps.  This was the first municipal solarium in Britain.  In the first year, 562 cases were treated in almost 18,400 attendances – with immediate effect for new cases of TB fell from 413 in 1922 to 294 in 1927; deaths from 206 to 175.

Dr Connan would remark that:

Miserable ailing children, delicate, anaemic and flabby are being turned into plum, rosy-cheeked youngsters full of life and spirit.

And by 1935 there were 30,000 annual attendances and 30 lamps in use daily, supported by three dedicated nurses.

All this came at a cost.  In 1931, Bermondsey spent £19,730 on maternity and child welfare – over one third more than that spent in the neighbouring boroughs of Camberwell and Southwark – and £36,877 on baths and washhouses – two thirds more than Camberwell. By 1938 the municipal debt stood at around £3m, compared to figures of £600,000 and £500,000 for Camberwell and Southwark respectively.

Side view of Grange Road Health Centre, solarium wing

Still, the local newspaper could conclude: (4)

So great have been the improvements that many parts of the borough are unrecognisable as the slum areas of years ago, and so long as the ratepayers are prepared to pay for these improvements they can have no grievance against their Council.

In 1925, Alfred Salter had looked forward to turning Bermondsey into a:

New Jerusalem, whose citizens shall have reason to feel pride in their common possessions, in their civil patriotism, in their public spirit, in the joint sharing of burdens, and their collective effort to make happier the lot of every single dweller in their midst.

Times change.

Grange Road Health Centre on a grey day earlier this year

Sources

(1) British Medical Journal, ‘Social Progress in Bermondsey’, Vol. 2, No. 3529 (Aug. 25, 1928)

(2) Fenner Brockway, Bermondsey Story: the Life of Alfred Salter, 1949

(3) Foreword to DM Connan, A History of the Public Health Department in Bermondsey, 1935

(4) This quotation, the one that follows and the preceding figures are provided in Sue Goss, Local Labour and Local Government.  A study of changing interests, politics and policy in Southwark, 1919-1982, 1988

All the illustrations come with permission from Southwark’s excellent Local History Library. Do visit it to find out more about the history of this fascinating borough. Some images have been placed in the public domain by the Wellcome Trust.

Woolwich’s Interwar Health Centres: ‘monuments to man’s achievement and to his folly’

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1920s, 1930s, Woolwich

This isn’t a party political blog but if you’re looking at Woolwich an understanding of the history and role of the local Labour Party is essential.

November 1919 Election flyer

The town – as many still preferred to call it – was home to a skilled and highly-organised working class.  Its Labour Party was the first in the country to enrol individual members and it was the largest local party in the country – averaging between 4000-5000 members – for most of the interwar period.

This was a relatively affluent working class and one with generally moderate politics.  You won’t come across the soaring socialist rhetoric that was a feature of Bermondsey politics, say.  What you will find is a solid commitment to fair wages and proper recognition of trade union rights and a practical concern for those essentials of decent living – health and housing.  We’ll look at the former today.

Woolwich Town Hall, opened by Will Crooks MP in 1906

Labour had first won control of the Borough Council in 1903, winning 25 of the 36 seats. One of its first actions was to establish a milk depot to supply sterilised milk at affordable prices to nursing mothers unable to breast-feed. By 1908, the depot was serving 328 infants – 12 per cent of the Borough’s total.   But Labour had lost control in 1906 and the cost of the scheme – and its taint of ‘municipal trading’ – led to its closure by local Conservatives.(1)

After this false start, the interwar period would see Labour secure its hold on local power – excepting a three-year blip from 1931 – and implement a comprehensive health programme for the Borough.

The environment would be improved by providing good quality housing and open space.  Ill-health would be curtailed by education from health visitors, classes and exhibitions. Sickness would be treated by health professionals working as a team.  And all would occur within a democratic framework mobilising individual self-help and supplying collective means.(2)

They didn’t bother much with jargon then but if we were to apply our own this was an impressively holistic approach and, indeed, the very model of joined-up government.

There’s much to say but we’ll focus on just a few elements here.

The Council’s first health visitor – primarily concerned with expectant and nursing mothers and their children – had been appointed in 1906.  By 1935, 97 per cent of infants under one year were visited by a much expanded team.(3)

From 1925, the Council ran a Health Exhibition in the Town Hall in conjunction with an annual Health Week.  The first was attended by 25,551 people; in the two succeeding years, some 10,000 attended the week’s lectures and talks.(4)  I’ll try not to overwhelm you with figures but they are a beguiling indicator of solid achievement and were, naturally, much touted by the Woolwich powers that be.

Accompanying brochures and later handbooks advertised the full range of Council services.  In 1937, the Library notice promoted ‘Healthy Minds – A mind biased and cluttered with half-truths is as useless as an unhealthy body’.

The advert for the Council’s in-house electricity supply department proclaimed: ‘Another great health service! A clean home, free from dirt, dust and fumes is a great asset to good health’.

I told you it was an holistic approach.

In bricks and mortar terms, the flagships of the Council’s agenda were its health centres.  In 1915, one infant welfare centre was operating; by 1935 there were eight.  These were initially regular clinics convening in ad hoc premises but the Council increasingly moved to build comprehensively-equipped and dedicated buildings.

The Eltham Health Centre on Westhorne Avenue, sited in the midst of the Council’s massive Eltham housing estate, was the first of these.  Opened by Arthur Greenwood, the Labour Minister of Health, in February 1931, this was the first infant welfare centre to also incorporate the London County Council’s schools medical service on its premises – allowing children to be monitored and treated from birth through to 14.

The Centre housed GPs’ and dental clinics, weighing rooms, a dispensary and a lecture room seating 120. To Greenwood, it was all a ‘wonderful temple’:(5)

a very beautiful building and it appealed to him because it was a source of health work. To him politics was concerned with the day-to-day life of men, women and children.

Miss Crout, chair of the Health Committee, urged local mothers to use it.  (Mabel Crout had first been elected to the council in 1919. She would serve over fifty years – as councillor and alderman – in  total.)

Typically for Woolwich, the Centre was a triumph of direct labour – designed, by Borough Engineer, J Sutton in collaboration with Medical Officer of Health, Dr Macmillan, and built by council employees at a cost of £5500.

The maternity and infant welfare centre in Plumstead was enlarged and expanded in the following year and Woolwich’s second purpose-built centre was opened in Market Street in January 1939.

Market Street Health Centre architect’s drawing

In the Council’s circumspect words, this was: (6)

A solid building in keeping with its predecessors, yet thoroughly modern and up-to-date in its planning…one which is eminently suitable for the ever-increasing health services of a metropolitan borough.

The Health Centre today

Woolwich wasn’t flashy.   Architecturally, there’s no comparison with the modernist Finsbury Health Centre of the same period.  The Centre was an in-house enterprise, designed once more by the Borough Engineer and built, at a cost of £18,066, by direct labour.

With the exception of the six consultants, its staff were council employees too.  It’s a lengthy list but worth giving as a flavour of the range of the Centre’s provision: five part-time medical officers, four assistant medical officers, an anaesthetist, six part-time vaccination officers, three part-time dental officers, a  part-time public analyst, 17 sanitary inspectors, 12 health visitors, three TB visitors, 16 clerks and a dispenser.

Main entrance

The building itself incorporated maternity and infant welfare services alongside the LCC’s schools medical service.  Additionally it housed orthopaedic and electro-therapy rooms.  Whilst infant life and mothers’ welfare were the overwhelming focus of the municipal medical provision of the day, the latter – alongside a chiropody clinic – also catered for adult males.

Ground floor plan

The Centre contained one new feature: air raid shelters – two 3ft 6in wide trenches constructed of reinforced concrete entered, in sad juxtaposition, from the pram sheds.  This and the date puts the comments of Lord Horder, the leading physician who opened the building, into context:(7)

If such a magnificent centre had been provided in any other country than this the propaganda minister and his satellites would see to it that the world knew what was being done…Woolwich now had the last word in health centres.  What they were doing in Woolwich would make the pomp of dictators look ridiculous.

Councillor Darby added that the centre was ‘a monument to man’s achievement and to his folly’:

While they marvelled at man’s ingenuity, they should ponder on the grim necessity of the concrete trenches which formed the air raid shelters. He expressed the hope they would not be needed…

But they were.  Woolwich – a military and armaments centre – suffered heavily in the war.  In fact, the Market Street Health Centre survived; that in Eltham was destroyed by bombing in 1941 and not rebuilt.

But in the meantime the centres and Woolwich’s wider health efforts had saved lives.  By the 1930s, infant mortality rates had halved – from 106 per 1000 in 1918 to 42 per 1000 in 1930.  Neo-natal deaths (within four weeks of birth) fell from 109 per 1000 to 44 in the same period.  Such rates were falling generally in the interwar period but detailed analysis supports the common-sense view that Woolwich’s generous provision made a difference.(8)

The Labour administration could justly conclude:(9)

the result of all this work, organised scientifically to proceed with regularity through the year, is that Woolwich can now claim, despite its great industrial areas, to be one of the healthiest boroughs in the kingdom.

Woolwich – as you would expect given its defence connections – was a patriotic borough but it is fitting that it chose to commemorate the death of the monarch in 1936 by issuing a pamphlet on The Care of the Mother and Child during the Reign of King George V.  

For the council, the preservation and betterment of life, and particularly that of its most vulnerable citizens, was its central concern.

Sources:

(1) Lara Marks, Metropolitan Maternity: Maternal and Infant Welfare Services in Early Twentieth Century London (1996)

(2) As Esyllt Jones argues in ‘Nothing Too Good for the People’: Local Labour and London’s Interwar Health Centre Movement, Social History of Medicine, vol 25, no.1, February 2012

(3) Data from Marks, Metropolitan Maternity

(4) Woolwich Labour Party, Twelve Years of Labour Administration, 1919-1931 (1931)

(5) Eltham Times, 20 February 1931

(6) Programme marking the opening of the Central Health Centre, Market Street, 14 January 1939 by Rt Hon Lord Horder

(7) Quoted in the Kentish Independent, 15 January 1939

(8) As concluded by Lara Marks, Metropolitan Maternity, p124

(9) Woolwich Labour Party, Twelve Years of Labour Administration, 1919-1931 (1931)

Original images above are from the wonderful local history collection of the Greenwich Heritage Centre and are used with their permission.  A big thank you to the helpful staff of the Centre.

Finsbury Health Centre: ‘Nothing is too good for ordinary people’

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1930s, Finsbury, Lubetkin

Finsbury Health Centre is not your usual obscure and unsung piece of municipal design.  Even today, somewhat faded and hidden behind some rather overbearing vegetation, it looks something special.  In its day, it was famously daring in both vision and design – in both its ideal of comprehensive, unified and free healthcare for all and in the bold architectural fulfilment of this ideal.

Finsbury was a typically overcrowded and poor inner London borough.  But it was one with an unusually radical political history, rooted in the close-knit artisanal trades of the area.  It elected its first Labour councillor in 1900 and Labour gained its first – bare – majority in 1928.  Though the party lost heavily in the debacle of 1931, Labour regained – and retained –  a secure hold on power in 1934.  The council intended to use that power purposefully.

The driving figures in this were the council’s leader, Alderman Harold Riley, a local teacher descended from a Black Country mining family, and Councillor Chuni Lal Katial, a recent migrant from India, now a GP practising in the borough and chair of the public health committee.

The 1936 Public Health (London) Act empowered local authorities to provide medical services to their local population.  Finsbury Council took up this challenge but aspired to more.  Its Finsbury Plan outlined a far-reaching and coordinated strategy to elevate the conditions and well-being of the borough’s people.  It included a health centre, baths, libraries and nurseries.   Whilst war and financial difficulties prevented the entirety of that vision being fulfilled, the health centre was achieved triumphantly.

It was Katial himself who approached the modernist architectural firm of Tecton to devise plans for the clinic – the first public commission of a modernist design.  Of the proposals submitted, the council selected the most expensive for its quality and space.   The building was intended to live up to the maxim of its chief architect Berthold Lubetkin and the principles of its commissioners: ‘Nothing is too good for the workers’.

The illustrations below – part of the design outline provided by Tecton – contrast the ‘open planning’ ideals of the design to the heavy and rather overbearing architecture that typically preceded it.

Lubetkin believed the purpose of modern architecture was ‘to improve…the living conditions of the people, to create a language of architectural forms which…conveys the optimistic message of our time – the century of the common man’.

But his genius lay in the humanism of this ideal.  The Centre was to be accessible and inviting, a drop-in centre before the term had been invented.   For Lubetkin, ‘the centre’s opening arms and entrance were a deliberate attempt to introduce a smile into what is a machine’.

The brochure which marked the opening of the Centre, noted more dryly:

Care has been taken to give to the whole structure a light and clean appearance, to make it an edifice to the splendid service it represents; a building which will inspire confidence through its thoroughly modern and up to date appearance.

Glass bricks at the front entrance and side wings, red-painted columns, sky-blue ceilings, an open-plan reception – all were both practice and propaganda for a life lived more fully, more openly, more colourfully by a working population immured in poverty.

And if that wasn’t clear, murals on the wall exhorted the Centre’s users to ‘Live out of doors as much as you can’ and seek ‘Fresh air night and day’.

Finsbury’s ‘megaphone for health’ spoke loudly of a better, healthier life.

Practically, the Centre incorporated doctors’ surgeries, an antenatal and mother and baby clinic, TB clinic, chiropody clinic, dental surgery and solarium. The solarium provided ultraviolet-ray treatment to the children of the polluted and sun-starved borough – on chairs designed by Alvar Aalto.

The basement included facilities for cleaning and disinfecting bedclothes and a lecture theatre, even a mortuary for those past benefiting from the Centre’s services.

The Centre opened in 1938. Cllr Katial spoke to the thinking which inspired it:

For some time the disadvantages of a service which has grown up piecemeal, retarded in its development and scattered here and there through lack of accommodation, have been only too apparent to my council.  Fully appreciating these difficulties, and actuated by a desire vastly to improve existing facilities and to establish new services, we have unanimously gone forward to erect this new health centre.  Its opening marks…the dawn of a new era in public health service

It’s a dry, almost bureaucratic, language – the stuff that makes municipalism hard to sell and Municipal Dreams seem almost oxymoronic.  But embrace that studied practicalism: it is precisely this realism and eschewal of rhetoric that changed lives. (It’s true, however, that Lubetkin always had the best lines. Those translucent glass walls seen above were intended to be ‘as beautiful as the hair of a beautiful young girl in the summer sunshine.’)

Barely a year later, Britain went to war and the Centre was pressed into service to meet the needs of more immediate casualties of man’s inhumanity to man but it was already an exemplar and a promise of a better tomorrow.

One year after the Beveridge Report itself seemed to herald that tomorrow and as the thoughts of ordinary people were already turning to winning the peace, in 1943 a poster was issued by the Army Bureau of Current Affairs which used the Finsbury Health Centre as its central symbol of the new postwar world.

In the event, the poster was deemed too radical.  Churchill himself apparently considered its depiction of a child with rickets in a slum setting to be a ‘libel’ on working-class conditions.  The poster was withdrawn but the aspirations which it represented that Churchill either feared or couldn’t comprehend were not so easily suppressed.  Labour secured a landslide victory in the 1945 general election and the Finsbury Health Centre was to be a model for the National Health Service established three years later.

Today, it’s a Grade 1 listed building but it looks a little tired and that sparkling vision of municipal healthcare has been superseded.  At the time of writing, it is still a local health centre but there have been plans to sell off the building and relocate its services.  Opposition from local residents and architectural campaigners seem to have stalled these for the time being but the outcome remains uncertain.

What is certain is the practical idealism of the Centre’s creators.  Their belief in an ethos of public service and their implementation of the principle of public provision of healthcare for all, free of the distortions of market and profit, is as relevant today as it has ever been.

Sources:

The Save Finsbury Health Centre blog is a vital source for this article and for anyone concerned for the future of the Centre.  There are many webpages focusing on the Modernist architectural heritage of the Centre; the best is in BD Online.

Bermondsey’s Health Education Campaign: ‘There is no wealth but life’

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1920s, 1930s, Bermondsey

The claim that Bermondsey might ‘be entitled in a few years to be regarded as one of Britain’s health resorts’ might seem pretty far-fetched. That claim made in 1928 – when the borough was one of London’s poorest and, in the words of the same speaker, ‘one huge slum’ – seems ludicrous.

Bermondsey: aerial view, 1926

But that was the ambition of Bermondsey’s new Labour council and its pioneering officials. And that was the goal of Alfred Salter – constituency MP, borough councillor and popular local GP – who articulated the dream.

Salter, with the indispensable support and industry of his wife Ada, was the driving force behind what became known as Bermondsey’s Revolution. He and his Labour colleagues believed ‘with Ruskin that “there is no wealth but life.”’

The means to defend, extend and enhance life that the Council mobilised were varied.  We’ll look at those too but this entry focuses on one area in which Bermondsey can claim to be unique – the design and scope of what was called (unashamedly in those days) its propaganda for health.

The campaign began in 1924 with a report by the borough’s then Medical Officer of Health, Dr King Brown, unpromisingly entitled, ‘Education of the Public in Hygiene’.   Behind the bureaucratese lay a missionary zeal shared with the Council leadership to improve working-class lives and conditions so systematically undermined by ‘Capitalism and Landlordism’.

The Council embraced the report and King Brown’s successor, Donald Connan, pioneered a breadth and range of public health education unequalled in the country.  The knowledge that so much ill health was preventable – even in the cruel circumstances prevailing in Bermondsey – fuelled the campaign.

TB, rickets, rheumatism, heart disease, venereal disease, diabetes and a range of infectious and industrial diseases were targeted.   Improved lighting and ventilation in homes were encouraged.   Self-help measures around diet and personal cleanliness were powerfully advocated.

The first school lecture was given in February 1925.  There were 440 further by 1933.  School certificates in hygiene were first awarded in 1930 and extended to a practical and written Diploma in Home Nursing in 1933.

Talks were given to any and every local group or organisation that would take them and leaflets produced on a range of subjects – 30 different pamphlets were in circulation before the war.  ‘Electric signs’ and advertisements were also employed.

But ‘from the start it was recognised,’ states Dr Connan, ‘that the scheme could not be complete without street preaching and, to conform with the general plan, this had to be illustrated by lantern slides and films’.

The campaign’s intention to reach local people and the inventiveness of that approach is best seen in the ‘cinemotor’ vans that the council designed and built to show films in the streets and open spaces.  Three customised vehicles were in use by 1939, taking their electricity supply from street lamps modified for the purpose.  (There is an imagination at work here rooted in realities which couldn’t be more prosaic yet more pressing.)

As the programme developed and its resources grew, a successful pattern emerged.   Dr Connan recounts: ‘Our usual procedure with an audience is to give a short talk illustrated by lantern slides, then show a film, invite discussion, and finally give a pamphlet on the same subject’.

What his formal language doesn’t capture is the excitement that these shows could generate at a time when so much of life was lived on the streets.  Naturally children were the most enthusiastic – shouting out or singing the captions to the slides and silent movies – but they helped to gather a crowd and in the end as many as 100 to 250 people might gather to watch.

The shows took place generally in the spring and autumn as the films couldn’t be seen in the brighter days of summer.  Not that the British weather always cooperated: in 1927 only 19 outdoors showings were possible; in the warmer, drier year of 1930, there were 70.

Most films were made and shot in the borough – adding to the sense of local identity and pride that the Council promoted so successfully, crafted and created by council employees, notably Connan himself, Mr Bush, the Chief Administrative Officer and Mr Lumley, its Technical Officer and Radiographer.  (These unsung heroes of municipalism deserve their name-check.) The Direct Labour Department made the sets.   Sound was added as the talkies arrived.

By 1938, the Council had a catalogue of 33 films of which 20 had been made by the borough.  When the scheme ended, a total of 30 films had been produced locally of which 16 survive.

Some advertised the public health services and achievements of the council.  Others such as Where There’s Life, There’s Soap (1933) and The Empty Bed (a stark warning of the risks of not immunising against diphtheria, made in 1937) conveyed straightforward advice on healthy living and disease prevention.

If the films were didactic, they were generally gently so – advisory rather than admonishing.  The 1930 film, Oppin, was unusual in being more direct in its criticism of the exploitative conditions prevailing in the Kent hop fields where many East Enders traditionally worked in the late summer.

If – to modern eyes – they appear guileless, that was deliberate.  For Connan:

The success of the films depends upon the plot which must be devised in such a way as to ensure a simple continuity of ideas throughout. The principle followed in preparing the pictures has been to make them self-explanatory…To enforce the lesson the greatest care has been given to subtitles. These must be simple and accurate, and while conveying a considerable amount of information, they must be concise and pointed.

If this seems patronising, remember that Bermondsey’s revolution was proudly home-grown and, literally in this case, won in the streets.  Its architects – whether middle-class Christian socialists such as the Salters, dedicated professionals such as Donald Connan or the working-class rank and file of Bermondsey Labour Party – wanted life and a fuller life for their people.

By the late thirties, they could look back on a record of solid achievement – a quantifiable improvement in all the key indices of health and a more intangible, qualitative shift in Bermondsey’s sense of itself and the expectations of its people.

There were wider social changes in this period, of course, but the advocacy of reforming local councils and the practical measures they implemented were a part of that change.

By 1935, Connan could already look back on one notable improvement in people’s circumstances.  He began by noting ‘a high degree of personal cleanliness is almost universal’.  But he went on to say that:

Possibly the most striking change is that which has taken place in the clothing of women and girls. Examples of medieval armour formerly worn are now rarely to be seen, and silk and artificial silk garments are almost as common in Wolseley Buildings [a Bermondsey tenement block] as they are reported to be in Berkeley Square.

Perhaps the Council’s film, Health and Clothing, made in 1928, played its own small part in this.

Sources:

The original images used here and much supporting archival information will be found in the Southwark Local History Library which anyone interested in learning more of Bermondsey’s past should visit. 

A major source for further information of Bermondsey’s public health campaigning is the Wellcome Trust’s online exhibition Here Comes Good Health!   You can view some of the films there and see additional photography.   Images above are taken from their site under the Creative Commons attribution.

Fenner Brockway’s Bermondsey Story: the Life of Alfred Salter (1949) is the best text on ‘Bermondsey’s Revolution’.  D.M. Connan, A History of the Public Health Department in Bermondsey (1935) provides the insider’s view and the direct quotes above. See also Bullman, Hegarty and Hill, The Secret History of our Streets (2012) for additional information on Bermondsey history.

Elizabeth Lebas’ book, Forgotten Futures: British Municipal Cinema, 1920-1980 (2011) contains a chapter – ‘When Every Street Became a Cinema’ – on Bermondsey.