Health Experiment that showed the way

review of "The Peckham Experiment"

The Peckham Health Experiment in the 1930s might provide the basis for a new 1990s model, says Stephen Joseph.

Healthcare is of course capable of becoming a private service albeit hugely deformed – planning less so. In these circumstances, the temptation is to keep heads down, campaign to keep what we’ve got – or hope it won’t be necessary to campaign – and lose any wider vision altogether.

This would be a pity. For planning originated from a concern about health – not the current concern about individual health, waiting lists, nurses pay or the potential for making money out of other people’s misfortunes, but a concern for real, genuine, public health.

Victorian campaigns for urban parks and open spaces were fought on public health grounds. Arguments for garden cities and new towns were couched in terms of making healthier settlements, both old and new, even up to the war and beyond. There were strong links between the arguments for the creation of the planning system and the creation of the National Health Service after the war.

But ironically, one of the most influential projects behind both arguments has been virtually forgotten, perhaps because it fits uneasily into the present day ideologies and practice of both planning and the NHS.

This is the Pioneer Health Centre in Peckham, south east London. Health centres are everywhere nowadays, of course, but none are like the Peckham centre was.

For behind the Peckham centre was a whole philosophy of health care which the NHS has lost. Scott Williamson and the other doctors who founded the centre saw people as part of their environment, not separated from or superior to it. Disease is literally ‘dis-ease’ – not being at ease with the environment.

What the Peckham centre set out to do was nothing less than reduce that ‘dis-ease’, to provide an environment that promoted health not opposed it.

The centre looked – still looks (it’s still there) - more like a ‘leisure centre’ than anything health related. Three large concrete platforms over supporting pillars surrounded a central space with a swimming bath, with mainly glass partition walls. There was very little equipment to start with. All growth came from the users.

It was ‘designed to be furnished with people and with their actions, in a design which invites social contact, allowing equally for the chance meeting and for formal and festive occasions as well as for quiet familiar grouping’.

In effect, Peckham combined the facilities now provided separately, if at all, by NHS primary care, youth, community and leisure services, libraries and arts, under-five provision such as nurseries, community care and social services, as well as a theatre and a cafeteria. But all the action in the building came not from professional leadership but ‘arose spontaneously out of the environment freely impinging upon the families as they use it’.

It was a family club, open to membership of all families within a mile radius – walking distance – of the centre. The family subscriptions and small charges for activities made the centre self-supporting.

The family was the basis of the Peckham centre. Given the era and area in which it operated, there was very apparent gender role stereotyping – the book emphasises improvements in ‘women’s knowledge of housekeeping’ – but in fact women involved in the centre found it overcame these roles and made them ‘totally different people’ as one put it.

Again fitting the times, the Peckham founders displayed a touching faith in rationality – science’s power for good. The Peckham Centre was for the founders ‘a laboratory for the study of human biology.’ The aim of the whole enterprise was to make the human animal as well as possible. It was ‘a locus in society from which the cultivation of the family as the living cell or unit of society can proceed’ so that the family evolves as part of a ‘live organised society’.

Peckham offered a self-organised, cross-generational community, not just ‘community leisure activities’, with the ‘health overhauls’ very much in the background. This real community focus contrasts with current urban centres, whose public nature has been eroded. Commercial uses have been able to outbid housing, especially low-cost housing, so city centres are now little more than an aggregation of individual acts of commerce, dominated by shopping malls and superstores. Artificial communities are imposed in place of genuine ones, against local opposition. Car-based living adds to this alienation even more.

The book about Peckham, The Peckham Experiment published in 1943, was one of the key social documents used to show what the war was being fought for. Yet the NHS found no room for the Peckham vision: most of its statistics were lost in the war so when government officials came to inspect, they could only see healthy people, not the figures that showed just how healthy they were compared to others in similar classes and environments or to their health before the centre opened. ‘This is not science as I know it’, said one health official.

As a result of this, the Peckham centre closed in 1950, through the building – a superb piece of architecture – still houses more traditional health and community care.

But the Pioneer Health Centre (PHC) organisation behind the Peckham centre stayed in existence, with the enthusiasm of several ex-users as well as of doctors and other staff keeping it going. PHC Ltd has recently enjoyed a renaissance: there has been interest shown not just from individuals in a number of professions discovering the book – reissued with new forewords in 1985 – but from organisations such as the World Health Organisation.

Consortium Developments, a familiar name to Town and Country Planning (T & CP) readers, has shown some interest in taking up the Peckham ideas within its new country towns. PHC people are trying to interest other such groups. There is considerable interest in applying the principles in other countries.

There should be plenty of lessons for planners and environmentalists in all this. Good places to live – the object of planning – need to consider health, and health is an aspect of the environment. Environmentalists in campaigning on transport, energy, pollution and other issues have taken up the public health issue of a century ago. Housing pressure groups deal with others. Peckham provides a new ingredient – a good social environment, with a community focus.

A final thought. Town and Country Planning Agency (TCPA) work in building new communities such as Lightmoor and in technical aid, emphasising people producing their own communities, creating their own physical environment. PHC emphasises people creating their own health-promoting social environment. Shouldn’t the TCPA and PHC be talking to each other?

Stephen Joseph works for the TCPA’s London Planning Aid Service. Quotes in this article are from:

The Peckham Experiment, by Innes Pearse and Lucy Crocker, republished in 1985