In part 1 of this post Southwark’s Archivist, Patricia Dark discussed the state of the borough’s health in the interwar period and introduced the work of Bermondsey’s public health pioneers. In part 2 we’ll discover what was going on at that time in the south of the borough.
Peckham had its own Pioneer – the Pioneer Health Centre, better known as the Peckham Experiment. It was the brainchild of two doctors, George Scott Williamson and Innes Pearce. Both were essentially academic physicians, and the Experiment grew out of their work on thyroid disease in the early part of the 20th century. For Williamson, “health” was something that existed separate from and in opposition to illness – understanding what it was and how to maximise it was simply impossible only studying pathology. Pearce’s work in an infant welfare centre in Stepney convinced her that any study of health – and any grassroots effort to improve health – had to be informed by, and grounded in, the family.
The initial phase of the Experiment began in 1926, in a house in Queen’s Road, Peckham: Pearce and Williamson worked with a group of birth control campaigners to measure whether access to health information would usefully empower people to improve their and their families’ health. It was a private members’ club, where – uniquely – the basic unit of membership was the family, not the individual. Members had access to medical workups, pre and postnatal care, and other specialist clinics, as well as a children’s nursery, space to socialize, and advice and help with other problems.
This initial phase ended in 1930, as it became clear that health information wasn’t enough to make people healthy – they had to have access to healthy, health-promoting environments. While the experiment could not reach into individual homes, it could influence members’ free time. Fundraising and design for a place where members could meet their physical, social, and mental health needs began, and the new centre opened in 1936.
The new centre operated on the same lines as the old – a private members’ club, whose basic unit of membership was the family; “family” including the partners of adult children, as Pearce and Williamson viewed premarital counselling as a crucial part of the process of creating a new family. The fee was a shilling a week per family and an annual health overhaul for each family member.
The health overhaul was crucial, both to collect data for the experiment and to inform and empower users. Centre staff took a detailed medical history, physical examination, and a full set of laboratory tests, before a one-on-one consultation; a member of medical staff explained the results and provided information on any appropriate diagnoses and potential treatments. However, although the Pioneer offered referrals, it didn’t treat members; autonomy of the individual over their own life was both a paramount value of the staff and a cornerstone of the experimental design. Someone who did not want to seek treatment for a problem – or who had a problem for which there was no current treatment – would receive information and support to help live with it.
The health centre’s building was built between 1933 and 1935 by Sir Evan Owan Williams, the engineer famed for Manchester’s Daily Express building. It was built using modern structural techniques which allowed a maximal amount of open space; for the most part, the centre was open-plan. This allowed families to separate and engage in different activities, while (for instance) parents could still monitor their children without hovering – it also allowed staff to unobtrusively observe members. As the experiment progressed, however, the open-plan design helped create a community – one where adults supervised, guided, and admonished any child, and children could interact and learn from a much wider and more varied group of adults than their own nuclear families.
The heart of the building was a swimming pool with a glazed roof. The centre’s café was to the side of the pool, separated from it by a wall with lots of windows. This gave mothers a place to chat – and provide informal support to each other – while keeping an eye on their children. There was also a gymnasium with a variety of apparatus: these were the two most appealing places for children in the building, but on opening they were allowed to use neither unsupervised – and their resulting frustration caused havoc in the newly-opened building. One member of staff, Lucy Crocker, discovered the solution – to allow children unsupervised use of these treasured places, provided they obtained signed permission from a staff member who was familiar with their abilities. This gave the researchers a chance to view them in their natural environment, as it were – they found that, not only did older children tend to watch out for younger ones, but more surprisingly, most children quickly found their own level of skill, and instinctively acted so they wouldn’t hurt themselves.
While sports and physical activities were a key part of the centre’s offering, it also offered space for reading and study, including a library, and space for a variety of classes and cultural opportunities. Crucially, staff did not plan and organise classes – that was the sole responsibility of members. However, staff would find space, tools, and materials for any group of members who wanted to learn, teach, or practice a skill, run an event, or hold a class. The one iron-clad rule was that nobody could claim space in the building for their private or group use without getting consent from other members.
To us, the Pioneer Health Centre seems like a bigger brother to a leisure centre: members could join exercise classes, or competitive leagues in sports and games like badminton, darts, and snooker. But the reality was that for many member families, the centre became an extension of their own homes: a place to hold parties, entertain friends, and even find a spouse! Knowledge and skills were passed between families and generations: fathers often used woodworking classes and clubs to make Christmas presents or hone DIY skills, and there were a variety of sewing circles to help new mothers clothe their babies as cost-effectively as possible – sharing child-rearing advice in the process.
The Centre’s heyday was the decade before the Second World War. Concerned at member families’ lack of access to high-quality nourishing food, the centre bought a farm in Bromley. Its small dairy herd, poultry farm, and arable fields provided organic milk, eggs, and produce at affordable prices: Williamson and Pearce were founder-members of the Soil Association. The farm also provided a place for members to work in the open, and space for camping. The centre also ran a school that attempted to apply the egalitarian, autonomous philosophy of the centre into practice in the realm of education.
However, the outbreak of war – and especially the beginning of the Blitz toward the end of 1940 – brought the centre’s life to a screeching halt. The farm was requisitioned by the RAF, and the centre was closed, as the very glass-heavy construction was both dangerous during an air-raid and difficult to black out. Although it reopened at the end of the war in 1945, it closed again, permanently, in 1950. Partly, this was due to financial problems – Peckham had been heavily bombed, and the building was in dire need of repair and equipment, leaving little money to run activities or recruit staff. Changes in the local population also didn’t help: Peckham had been heavily bombed, and the resulting displacement meant that many long-standing, active member families no longer lived in the area, while the population that now did was less able to spare the money for dues.
After the creation of the NHS in 1948, the centre petitioned unsuccessfully for central government funding. From Whitehall’s point of view, the centre was not free at point of service, and did not have an “open door” policy. On the centre’s side, the NHS was concerned only with the treatment of disease, not the cultivation of health, and the autonomous nature of the centre did not mesh well with the top-down bureaucracy of the NHS. Some members felt that the government felt threatened by a group of people who could organize and run such a large undertaking – especially one geared to personal autonomy and self-help – without the need for leadership.
However, the centre did have an impact. In part, that impact was shown by one shocking statistic: the annual health overhauls showed that only 10% of the membership were genuinely healthy. 30% of members had at least one illness, while the health of another 60% was impaired to some degree by symptoms of illness – often symptoms they didn’t realise they had.
This suggests that it is possible to function – even function well – in daily life when not completely healthy (or even unhealthy). However, the atmosphere of the centre – one where each individual’s right to make decisions about their own life was paramount, and where those choices were respected and validated – may well have helped people remain active and involved in their communities. Moreover, the sheer depth and breadth of activities available, and the support members had from staff and other members to access them, ensured that as many members as possible could stay active and involved – and therefore healthy. These are lessons that modern public health officials may do well to remember.