0:00:14 > 0:00:17- Aaah.- Aaah!
0:00:20 > 0:00:23At the beginning of the 20th century,
0:00:23 > 0:00:27Britain's health was in a sorry state.
0:00:27 > 0:00:32Life expectancy for men was just 48.
0:00:32 > 0:00:36And for women, an everyday experience like childbirth
0:00:36 > 0:00:38could be life threatening.
0:00:40 > 0:00:44My mother had a miscarriage, where she was, for three months,
0:00:44 > 0:00:47extremely ill,
0:00:47 > 0:00:49unconscious for a long time
0:00:49 > 0:00:51and really people didn't expect her to live.
0:00:53 > 0:00:57What treatment there was had to be paid for by the patient.
0:00:57 > 0:01:03Doctors were a luxury that many found hard to afford.
0:01:03 > 0:01:07It was only when we were quite seriously ill we asked him to come.
0:01:07 > 0:01:11We had all sorts of other scrapes, cuts,
0:01:11 > 0:01:13they just were bandaged up and hoped we got better.
0:01:15 > 0:01:21In fact, getting access to healthcare at all wasn't easy.
0:01:21 > 0:01:25This is a very, very ramshackle, chaotic, disorganised
0:01:25 > 0:01:28set of services, there's no doubt about that.
0:01:28 > 0:01:30With the system failing to deliver,
0:01:30 > 0:01:34many people took matters into their own hands.
0:01:34 > 0:01:37They organized their own health care in their own communities.
0:01:37 > 0:01:41If people wanted something done they had to do it for themselves
0:01:41 > 0:01:44and the best way to do it was by clubbing together.
0:01:45 > 0:01:48And others experimented with new ways to stop people
0:01:48 > 0:01:51from getting ill in the first place.
0:01:51 > 0:01:54We were guinea pigs, it wasn't just me.
0:01:54 > 0:01:58We were all guinea pigs. And it changed my life.
0:02:00 > 0:02:04This is the story of how ordinary people, GPs,
0:02:04 > 0:02:08midwives and local councils coped with sickness
0:02:08 > 0:02:11and disease at home and in their communities.
0:02:11 > 0:02:15Of the struggle to improve the nation's health.
0:02:17 > 0:02:21And of how radical new ideas would eventually help create
0:02:21 > 0:02:25a system of healthcare for all.
0:02:43 > 0:02:47Efforts to deal with the poor state of Britain's health
0:02:47 > 0:02:49had begun during the 19th century.
0:02:50 > 0:02:54Newly created public health departments had organised
0:02:54 > 0:02:58programmes of slum clearance, and improved sanitation
0:02:58 > 0:03:03that brought an end to epidemics of infectious diseases.
0:03:03 > 0:03:08The emphasis now switched to the health of the individual.
0:03:09 > 0:03:13What had happened was we had lost the epidemics of cholera, typhus,
0:03:13 > 0:03:16even smallpox was going into decline
0:03:16 > 0:03:19because the sanitary surveillance had been so good.
0:03:19 > 0:03:24By the early 20th century, the focus is shifting from the environment
0:03:24 > 0:03:27to the person, to the individual.
0:03:29 > 0:03:32The general health of people in Britain at the time
0:03:32 > 0:03:36was a cause for concern - highlighted by the shockingly
0:03:36 > 0:03:39poor state of volunteers for the Boer War.
0:03:41 > 0:03:45Most had been rejected for being too small and under-weight.
0:03:49 > 0:03:53Government committees were set up to look into the problem of what
0:03:53 > 0:03:57they described as "national degeneration", and in particular,
0:03:57 > 0:04:00the high numbers of children who died in the first year of life.
0:04:04 > 0:04:07There was a growing realisation that the high cost of infant deaths
0:04:07 > 0:04:10was weakening the country at that time
0:04:10 > 0:04:14and Britain was losing pace with international competitors such as
0:04:14 > 0:04:19Germany, America and Japan. So to ensure Britain was producing
0:04:19 > 0:04:22a fit, healthy, productive industrial population,
0:04:22 > 0:04:24attention came to be focused on infant welfare
0:04:24 > 0:04:26and all sorts of different reforms passed
0:04:26 > 0:04:29to try and improve the standard of infant health.
0:04:33 > 0:04:36In 1900, out of every 1,000 babies born,
0:04:36 > 0:04:41more than 150 would die before their first birthday.
0:04:44 > 0:04:47Their mothers faired little better.
0:04:47 > 0:04:50Maternal deaths in childbirth were as high as they had
0:04:50 > 0:04:52been in the 1850's.
0:04:55 > 0:04:58So, if the nation's health was to be improved,
0:04:58 > 0:05:02the moment of birth was an obvious place to start.
0:05:04 > 0:05:07The spotlight turned on midwives.
0:05:07 > 0:05:10They delivered most of the nation's babies and for centuries
0:05:10 > 0:05:12had worked independently from the medical profession,
0:05:12 > 0:05:16who'd shown little interest in them.
0:05:18 > 0:05:23They were untrained, unregulated and often unpaid.
0:05:25 > 0:05:29At the beginning of the 20th century everything changed for midwifery.
0:05:29 > 0:05:34There had been a campaign building up steam throughout the last 20 years
0:05:34 > 0:05:38of the 19th century looking at registering midwives
0:05:38 > 0:05:41and actually bringing in some kind of compulsory training.
0:05:43 > 0:05:47There was also a growing belief that given that midwives
0:05:47 > 0:05:50were delivering the vast majority of babies born in the country,
0:05:50 > 0:05:52there ought to be some way of knowing who they were
0:05:52 > 0:05:55and perhaps policing what they were doing.
0:06:01 > 0:06:06The campaign led in 1902 to the first state regulation of midwives.
0:06:08 > 0:06:11A Central Board was set up to ensure minimum professional standards
0:06:11 > 0:06:16and compulsory registration and training.
0:06:19 > 0:06:21But there was another problem.
0:06:21 > 0:06:25Midwives were self-employed and without a guaranteed income,
0:06:25 > 0:06:29they'd had to find other ways to supplement their earnings.
0:06:31 > 0:06:36Ilfra Goldberg remembers the novel approach of her village midwife.
0:06:37 > 0:06:41We had a wonderful midwife who doubled up as a chimney sweep
0:06:41 > 0:06:45and she used to go through the village in a pony and cart,
0:06:45 > 0:06:52white pony and cart and she had her chimney sweep brushes in the cart,
0:06:52 > 0:06:54but she also was a qualified midwife
0:06:54 > 0:06:58and people would stop her and she would come in and help
0:06:58 > 0:07:00with deliveries as well.
0:07:00 > 0:07:05I've never heard of a midwife also operating as a chimney sweep,
0:07:05 > 0:07:10but it certainly was true that midwives weren't that often
0:07:10 > 0:07:16operating purely as midwives. You find midwives taking in washing,
0:07:16 > 0:07:19taking in lodgers, minding other people's children,
0:07:19 > 0:07:24or doing piece work at home, simply because they could not
0:07:24 > 0:07:26earn enough money from delivering babies.
0:07:31 > 0:07:35By the mid-1930's, the reforms had turned midwifery into a far more
0:07:35 > 0:07:40professional service, but there just were not enough of them.
0:07:45 > 0:07:52In 1936, legislation was brought in which made local authorities
0:07:52 > 0:07:55pay midwives a salary and a pension.
0:07:56 > 0:08:00The changes attracted an influx of new recruits.
0:08:01 > 0:08:03Grace Lowe was one of them.
0:08:05 > 0:08:09Well, my mother left school at 14, as they would in those days,
0:08:09 > 0:08:13but she had always been determined that she wanted to be a midwife.
0:08:13 > 0:08:19Very much against her parents' wishes that's exactly what she did,
0:08:19 > 0:08:22so at 18 she went off to a hospital in Lowestoft
0:08:22 > 0:08:26and did her nursing training for three years.
0:08:28 > 0:08:30Grace then moved to London
0:08:30 > 0:08:35and by 1937 had fulfilled her ambition to qualify as a midwife.
0:08:35 > 0:08:39She began work in Walthamstow, in north-east London.
0:08:39 > 0:08:44But the training hadn't prepared her for the stark realities of the job.
0:08:45 > 0:08:50You never knew people were having twins. They would just appear.
0:08:50 > 0:08:53You didn't know if it was a breach birth,
0:08:53 > 0:08:56if there was something badly wrong with the child.
0:08:57 > 0:09:02There was no signs, no tests, people had very little care,
0:09:02 > 0:09:05so they never knew what they were going to
0:09:05 > 0:09:07or how it was going to happen.
0:09:07 > 0:09:11And she said that used to be really very frightening.
0:09:14 > 0:09:18The only equipment you could take, would be that which you could carry,
0:09:18 > 0:09:22so very heavy cylinders of gas and air, for example,
0:09:22 > 0:09:25midwives didn't tend to take with them so they didn't have any
0:09:25 > 0:09:29pain relief to offer women because it wasn't practical.
0:09:29 > 0:09:35One of the things that midwives did carry was ergot.
0:09:35 > 0:09:39This is a natural ingredient - it comes from mould on rye
0:09:39 > 0:09:42and it would be administered to women
0:09:42 > 0:09:45who were haemorrhaging after the delivery.
0:09:45 > 0:09:47And it acts by contracting the womb,
0:09:47 > 0:09:53which would hopefully help to stop bleeding. It was all reusable
0:09:53 > 0:09:57so when you have that thing in films where husbands are being asked
0:09:57 > 0:10:00to boil water, that's the reason why,
0:10:00 > 0:10:03so all this metal equipment could be sterilised.
0:10:08 > 0:10:11The focus on reform in Britain's maternity services
0:10:11 > 0:10:16had started to have an impact on infant mortality rates.
0:10:17 > 0:10:19From the beginning of the century
0:10:19 > 0:10:22to the 1930's, they had more than halved.
0:10:26 > 0:10:30But for women, pregnancy and childbirth was still a major
0:10:30 > 0:10:34threat to their lives and in an age before widespread contraception,
0:10:34 > 0:10:38the threat to them and their children was ever present.
0:10:44 > 0:10:49There'd be Mary, who was the eldest, myself, Margaret and John.
0:10:49 > 0:10:55And I did have two other little brothers - Robert and David.
0:10:55 > 0:10:57Unfortunately, they had died
0:10:57 > 0:11:01of what was just called in those days - convulsions.
0:11:03 > 0:11:07Janet's father was a miner, and in 1929 he left Scotland
0:11:07 > 0:11:10and moved the family south in search of work.
0:11:11 > 0:11:15The unemployment was dreadful and pits were closing everywhere
0:11:15 > 0:11:18and due to the pit closures in Lanarkshire
0:11:18 > 0:11:21dad came down to the Kent coalfield
0:11:21 > 0:11:24and people were coming from all over the country to Kent.
0:11:27 > 0:11:31Janet's father found a job, but life was tough
0:11:31 > 0:11:33and her mother's health suffered.
0:11:33 > 0:11:37Pregnant once again, she fell ill with a highly dangerous infection.
0:11:39 > 0:11:44My mother had a miscarriage and developed puerperal fever
0:11:44 > 0:11:47as they used to call it, general septicaemia,
0:11:47 > 0:11:49was rushed into Canterbury Hospital
0:11:49 > 0:11:52where she was, for three months, extremely ill,
0:11:52 > 0:11:57unconscious for a long time and people didn't expect her to live.
0:11:58 > 0:12:02Mary was 12 - the eldest, and I was eight
0:12:02 > 0:12:04and dad still had to go to work.
0:12:04 > 0:12:08If he didn't work, he wouldn't have been paid.
0:12:08 > 0:12:13And the terror that we felt - that's the worst terror I've ever felt
0:12:13 > 0:12:17in my life was to see mum being taken out.
0:12:19 > 0:12:23Against the odds, Janet's mother survived.
0:12:24 > 0:12:29But at that time 1 in 200 women died as a result of childbirth.
0:12:33 > 0:12:36For the better off, the risks were just as high
0:12:36 > 0:12:38but the experience was somewhat different.
0:12:40 > 0:12:45Rather than a midwife, they employed a doctor to deliver their babies.
0:12:49 > 0:12:51I don't think I was spoilt, was I?
0:12:51 > 0:12:55But there seemed to be a lot of attention being paid!
0:12:55 > 0:12:58Margaret Smart was brought up in Gloucester
0:12:58 > 0:13:02and has a unique record of her birth in 1935.
0:13:02 > 0:13:07Her father had a well-paid job and a passion for home movies.
0:13:23 > 0:13:27Dad was in insurance, he worked for General Accident.
0:13:27 > 0:13:30He started as an office boy and worked up
0:13:30 > 0:13:34to be one of...you know, manager or something I think.
0:13:34 > 0:13:39And then he bought an insurance broking business,
0:13:39 > 0:13:44so obviously we had a car, and a phone, this nice new house.
0:13:46 > 0:13:48Families either side were the same really.
0:13:58 > 0:14:02When it came to Margaret's birth, like all middle class families,
0:14:02 > 0:14:05her parents followed fashion and hired the local doctor.
0:14:07 > 0:14:11There was a certain amount of kudos related
0:14:11 > 0:14:14to having a doctor come to your house and deliver your baby,
0:14:14 > 0:14:17so there was very much an element of pride involved.
0:14:21 > 0:14:25They would very often also have what was called a monthly nurse
0:14:25 > 0:14:30to come and live in the house perhaps a week before the baby was due.
0:14:34 > 0:14:37And then stay for maybe two or three weeks afterwards
0:14:37 > 0:14:41and help with breastfeeding, help with caring for baby,
0:14:41 > 0:14:43those kind of things.
0:14:49 > 0:14:53What a dear little soul, wasn't I?
0:14:54 > 0:14:58What else can one say about that except I like biscuits
0:14:58 > 0:15:00and I've liked them ever since!
0:15:08 > 0:15:11Wealthier families believed that by hiring a doctor,
0:15:11 > 0:15:14they were getting a better service.
0:15:14 > 0:15:19But it turned out, that their confidence was misplaced.
0:15:19 > 0:15:22Curiously although it was fashionable to have a doctor,
0:15:22 > 0:15:27it was actually safer to be poor and have a midwife in that period.
0:15:27 > 0:15:30Doctors were very busy, they were in a hurry,
0:15:30 > 0:15:33they were dealing with lots of different cases,
0:15:33 > 0:15:36so you would get them trying to deliver babies
0:15:36 > 0:15:39before labour was complete or you would get them
0:15:39 > 0:15:41passing on infection because they'd been to an illness
0:15:41 > 0:15:43and then come straight to a birth.
0:15:49 > 0:15:53One of the reasons that doctors were so busy was
0:15:53 > 0:15:56because of the way they earned their living.
0:15:56 > 0:16:00They were self-employed - the more patients they had,
0:16:00 > 0:16:03the more money they earned.
0:16:03 > 0:16:08Doctors would decide where to practice on the basis of where
0:16:08 > 0:16:11they thought they could get the best custom
0:16:11 > 0:16:16and what that meant in effect is that in some parts of the country
0:16:16 > 0:16:22where availability and access to practitioners and specialist care
0:16:22 > 0:16:25was actually much better than in other parts of the country.
0:16:25 > 0:16:27And people have calculated
0:16:27 > 0:16:30that there was something like a six-fold variation
0:16:30 > 0:16:33between towns in Britain.
0:16:35 > 0:16:38In rural areas, coverage was particularly sparse.
0:16:40 > 0:16:44In 1920, Mary Phillips' father found his first job as a doctor
0:16:44 > 0:16:48in a large rural practice in Barnstable in north Devon.
0:16:51 > 0:16:53They set off on a motorbike and sidecar
0:16:53 > 0:16:58to go the way from Sussex to North Devon.
0:16:58 > 0:17:02And my mother was in fact a trained nurse.
0:17:04 > 0:17:08She would drive the motorbike and dad would ride in the sidecar.
0:17:12 > 0:17:15With no special GP training required at the time,
0:17:15 > 0:17:19Mary's father, who had qualified as a surgeon, also performed operations
0:17:19 > 0:17:23on his patients at the local hospital.
0:17:25 > 0:17:31They did a bit of everything, I mean, he delivered babies,
0:17:31 > 0:17:35he operated on appendixes and hernias,
0:17:35 > 0:17:40he would do a radical breast operation for cancer.
0:17:40 > 0:17:43He was on call six days a week,
0:17:43 > 0:17:48he had one day off on a Saturday or Sunday.
0:17:48 > 0:17:52Of course we had staff - we had a cook
0:17:52 > 0:17:55and a housemaid and we had a nanny.
0:17:57 > 0:18:01My father got a number of private patients
0:18:01 > 0:18:06and they used to come to the house at two o'clock in the afternoon,
0:18:06 > 0:18:09and our drawing room was used as a waiting room
0:18:09 > 0:18:12and we children were kept out, you know.
0:18:12 > 0:18:19We had a maid who wore a frilly apron who used to answer the door
0:18:19 > 0:18:23and then Dad with take them into the consulting room.
0:18:32 > 0:18:34But the cost of a visit to the doctor
0:18:34 > 0:18:36put treatment beyond the reach of most.
0:18:36 > 0:18:41If the nation's health was to improve, the low paid needed
0:18:41 > 0:18:44better access to doctors.
0:18:45 > 0:18:49The answer came from health insurance schemes set up by
0:18:49 > 0:18:53Friendly Societies and trade unions dating back to the 19th century.
0:18:56 > 0:19:00Using this framework from 1911 onwards, the state would make
0:19:00 > 0:19:05a contribution towards health insurance for people on low pay.
0:19:07 > 0:19:09This national health insurance scheme
0:19:09 > 0:19:13is a very important intervention by the government. It was the first time
0:19:13 > 0:19:16that the government had intervened to provide medical services
0:19:16 > 0:19:18for a group of the population
0:19:18 > 0:19:21other than the very poorest sections of the community.
0:19:24 > 0:19:28All workers who earned up to £160 a year
0:19:28 > 0:19:31would now be entitled to health insurance.
0:19:34 > 0:19:36The way it was set up
0:19:36 > 0:19:40was that an employee paid in a certain amount of money,
0:19:40 > 0:19:44the employer paid in some and some also came from the government
0:19:44 > 0:19:49and that built up an insurance fund which gave them a sickness benefit
0:19:49 > 0:19:55and the right to access medical care, in other words, to see a GP.
0:19:59 > 0:20:03The aim of the scheme had been to increase the number of people
0:20:03 > 0:20:04who could afford treatment.
0:20:06 > 0:20:10But it still left almost half the population without any help.
0:20:15 > 0:20:20The middle classes, people above that income level,
0:20:20 > 0:20:22were obviously excluded,
0:20:22 > 0:20:26so they were still in the position of having to buy their medical care
0:20:26 > 0:20:29on the market, as it were.
0:20:29 > 0:20:33And other groups who weren't in work were also excluded.
0:20:33 > 0:20:34Women in the home,
0:20:34 > 0:20:38and children, people under 16 years.
0:20:41 > 0:20:43For those who'd been left out,
0:20:43 > 0:20:47it was a case of finding other ways to manage.
0:20:52 > 0:20:55Some, like Ilfra Goldberg's family,
0:20:55 > 0:20:59had to rely on informal arrangements with their doctor.
0:20:59 > 0:21:03As a teacher, her father earned too much to qualify for help,
0:21:03 > 0:21:05so the doctor would charge the adults,
0:21:05 > 0:21:08but would waive fees for the children.
0:21:11 > 0:21:13Money was very tight.
0:21:13 > 0:21:16Certainly, some people in the village were charged,
0:21:16 > 0:21:21and I think we regarded ourselves as fortunate,
0:21:21 > 0:21:24and, in a sense, in debt to the general practitioner
0:21:24 > 0:21:28that we weren't charged.
0:21:28 > 0:21:30It was a two-way process, in a sense.
0:21:30 > 0:21:35Um...we would never have called him unnecessarily.
0:21:35 > 0:21:39My parents were very careful that it was only when
0:21:39 > 0:21:42we were quite seriously ill that we asked him to come.
0:21:42 > 0:21:44We had all sorts of other scrapes, cuts,
0:21:44 > 0:21:48quite severe cuts sometimes,
0:21:48 > 0:21:49which perhaps nowadays,
0:21:49 > 0:21:52one would have gone to an accident and emergency department
0:21:52 > 0:21:55or got some further help. We didn't.
0:22:03 > 0:22:06Some employers ran health insurance schemes
0:22:06 > 0:22:10that did extend cover to dependent wives and children.
0:22:12 > 0:22:14The job that Janet Dunn's father had found
0:22:14 > 0:22:17was in the newly-developed Kent coalfield
0:22:17 > 0:22:19and it came with a tied house
0:22:19 > 0:22:22and health insurance for the whole family.
0:22:25 > 0:22:28The benefit, of course, would mean that if you became ill,
0:22:28 > 0:22:30and my sister broke her arm
0:22:30 > 0:22:33and another sister dislocated her shoulder and so on,
0:22:33 > 0:22:37things that happened, you would be taken into Canterbury hospital.
0:22:37 > 0:22:39And that covered that.
0:22:39 > 0:22:42And also, I suppose, it paid for the local doctor.
0:22:44 > 0:22:48But the benefits for Janet's family would be short-lived.
0:22:48 > 0:22:52Working conditions in the mines were notoriously tough.
0:22:54 > 0:22:58The Kent coalfields were very, very deep and hot
0:22:58 > 0:23:01and the men used to describe it as Dante's Inferno.
0:23:01 > 0:23:03It was really dreadful.
0:23:03 > 0:23:07A lot of people who came only did the one shift, collapsed
0:23:07 > 0:23:11and were brought out and didn't go back again.
0:23:13 > 0:23:16The harsh conditions meant disputes were common,
0:23:16 > 0:23:19and Janet's father was sacked after going on strike.
0:23:25 > 0:23:26The family was evicted
0:23:26 > 0:23:30and their entitlement to health insurance soon ran out.
0:23:32 > 0:23:35Her parents had to find other ways to manage.
0:23:37 > 0:23:40Dad was wonderful in his little remedies.
0:23:40 > 0:23:43I remember my brother, John, when he was very ill
0:23:43 > 0:23:47and Dad used to go to the pub and bring a little miniature of brandy
0:23:47 > 0:23:50back and put a little teaspoonful in
0:23:50 > 0:23:54with the white of an egg and some sugar.
0:23:54 > 0:23:57And we were all fascinated with this.
0:23:57 > 0:23:59It smells lovely, looks lovely.
0:23:59 > 0:24:02And he used to just spoon this gently to little John.
0:24:04 > 0:24:08But Janet's mother became seriously ill during another pregnancy,
0:24:08 > 0:24:12and it was then that the consequences really hit home.
0:24:12 > 0:24:15Mother had pre-eclampsia.
0:24:15 > 0:24:19It's a very serious complication of pregnancy.
0:24:19 > 0:24:23So Mum expected to be taken into Canterbury hospital.
0:24:23 > 0:24:25And she was amazed when they said,
0:24:25 > 0:24:29"Oh, no, you don't go to Canterbury hospital."
0:24:29 > 0:24:30She said, "Why?"
0:24:30 > 0:24:35And they said, "Well, your husband doesn't pay to Canterbury hospital.
0:24:35 > 0:24:37"Because he's unemployed, you're not paying,
0:24:37 > 0:24:43"so you have to go to Etchinghill." To what was really the poor house.
0:24:43 > 0:24:46And she said, "Well, I refuse. I won't go."
0:24:46 > 0:24:49She did refuse to go.
0:24:49 > 0:24:55Dad and I between us, we nursed her and looked after her.
0:24:55 > 0:24:59She came through, but the baby was stillborn.
0:25:02 > 0:25:06The hard economic circumstances that Janet's family found themselves in
0:25:06 > 0:25:09were by no means uncommon.
0:25:09 > 0:25:12Britain was experiencing the worst depression
0:25:12 > 0:25:14of its industrial history.
0:25:15 > 0:25:18Unemployment reached 25 percent
0:25:18 > 0:25:23and many people found themselves in and out of work with little warning.
0:25:26 > 0:25:28Brenda Watkinson's parents
0:25:28 > 0:25:31were amongst those who were struggling to make a living.
0:25:33 > 0:25:35Mum and Dad were both in shop work.
0:25:35 > 0:25:38My father was a gentleman's outfitter
0:25:38 > 0:25:41in the days when you had pinstripe trousers and a black jacket,
0:25:41 > 0:25:44and my mother worked in grocery and provisions.
0:25:46 > 0:25:51Brenda's father volunteered at a doctor's surgery in Bermondsey in east London,
0:25:51 > 0:25:54helping run a local healthcare savings scheme
0:25:54 > 0:25:58which enabled patients to spread the cost of medical treatment.
0:26:00 > 0:26:03The scheme was called the PMS.
0:26:03 > 0:26:07I imagine I might have stood for Patients Medical Scheme.
0:26:07 > 0:26:11And my father had to ride around on his bike and collect money.
0:26:11 > 0:26:15And it was a thankless task because he was out in all weathers,
0:26:15 > 0:26:19often late at night, trying to catch up with people who hadn't been there the first time he called.
0:26:19 > 0:26:24They were out or hadn't got any money and were hiding behind the door.
0:26:24 > 0:26:28I remember thinking, "It's late and Mum and Dad are still poring over these books."
0:26:28 > 0:26:31Sometimes they were there for several hours,
0:26:31 > 0:26:37making sure each person's contribution was correctly into the ledger.
0:26:37 > 0:26:40But so many people, their earnings were up and down,
0:26:40 > 0:26:45and so their only way of making sure they were covered when they were ill,
0:26:45 > 0:26:47was to try and eke out a bit of money
0:26:47 > 0:26:51every so many weeks when my dad went around.
0:26:51 > 0:26:53Times were hard.
0:27:02 > 0:27:07In Britain, the tradition of self-help schemes for medical care
0:27:07 > 0:27:11had begun amongst workers and employers in the early 19th century.
0:27:14 > 0:27:17It was common for groups of workers in different workplaces
0:27:17 > 0:27:20to band together and to create some sort of fund
0:27:20 > 0:27:22or some sort of organisation
0:27:22 > 0:27:26that procured medical services for themselves and their families.
0:27:28 > 0:27:30These medical schemes came from employers
0:27:30 > 0:27:33appointing surgeons to look after their workers.
0:27:33 > 0:27:35Workers were very dissatisfied
0:27:35 > 0:27:38that employers had the power to appoint and dismiss the doctors,
0:27:38 > 0:27:41despite the fact that it was the workers themselves
0:27:41 > 0:27:43who were paying the salaries of these doctors.
0:27:43 > 0:27:45There were instances in which employers
0:27:45 > 0:27:48actually made a profit from these medical schemes.
0:27:52 > 0:27:55One scheme that was determined to do its best by its members
0:27:55 > 0:27:59was based in Tredegar in south Wales.
0:28:02 > 0:28:05Tredegar is a very small-knit community.
0:28:05 > 0:28:07People are very, very close
0:28:07 > 0:28:09Er...everybody knows everybody
0:28:09 > 0:28:11and everybody knows what's going on.
0:28:11 > 0:28:14There's nothing sacred in the town.
0:28:14 > 0:28:17At the beginning of the 19th century,
0:28:17 > 0:28:20the town had a population of just over 1,000 people.
0:28:22 > 0:28:25But the discovery of rich iron ore deposits
0:28:25 > 0:28:28soon turned it into a boomtown
0:28:28 > 0:28:31run by the Tredegar Iron Company.
0:28:35 > 0:28:37Tredegar was a company town.
0:28:37 > 0:28:39Everything revolved around the company.
0:28:39 > 0:28:43You either worked for them or you didn't work.
0:28:43 > 0:28:46Um...they controlled everything.
0:28:46 > 0:28:48They controlled people's lives.
0:28:50 > 0:28:53Production then switched to steel and coal.
0:28:53 > 0:28:55And, like most of the men in Tredegar,
0:28:55 > 0:28:57John's grandfather found work in the mines.
0:29:00 > 0:29:03But as demand for coal rose and fell,
0:29:03 > 0:29:05so did the fortunes of people in the town.
0:29:07 > 0:29:11There was a lot of unemployment. Money was hard to come by.
0:29:11 > 0:29:14And living conditions were quite harsh.
0:29:14 > 0:29:16There was a lot of overcrowding,
0:29:16 > 0:29:20with a two-bedroom house having anything from six to ten people
0:29:20 > 0:29:23or even twelve people living in them.
0:29:23 > 0:29:26A lot of houses didn't have running water or sanitary fittings.
0:29:26 > 0:29:30There was still a large amount of outside toilets
0:29:30 > 0:29:33at that particular time and people sharing toilets.
0:29:35 > 0:29:39The townspeople were determined to improve conditions for the workers,
0:29:39 > 0:29:42and by the early 20th century,
0:29:42 > 0:29:46had taken over the running of the local medical-aid schemes.
0:29:48 > 0:29:51Tredegar Workmen's Medical Aid Society was different
0:29:51 > 0:29:54to similar organisations in other parts of Britain.
0:29:54 > 0:29:57In the first place, the wives and children of worker members
0:29:57 > 0:30:00also received medical care under the schemes.
0:30:00 > 0:30:05Secondly, in South Wales, very, very different to everywhere else
0:30:05 > 0:30:10in Britain, a poundage system was utilised, whereby workers paid two
0:30:10 > 0:30:14or three pence in each pound, rather than a flat rate contribution.
0:30:15 > 0:30:19This meant that profit could be built up so that other kinds
0:30:19 > 0:30:22of medical services could be offered within the schemes.
0:30:22 > 0:30:24Tredegar became the most comprehensive
0:30:24 > 0:30:27of any medical aid scheme in the country,
0:30:27 > 0:30:31providing treatment from doctors and district nurses,
0:30:31 > 0:30:33to dentists and physiotherapists.
0:30:36 > 0:30:41'By the 1920s, something like almost 23,000'
0:30:41 > 0:30:44of the town's 24,000 population were members of this scheme,
0:30:44 > 0:30:47so it's almost a universal scheme.
0:30:48 > 0:30:53In 1915, Walter Conway became its secretary.
0:30:53 > 0:30:55'He was a good man.
0:30:55 > 0:30:59'He had this vision that he wanted the best.'
0:30:59 > 0:31:02He wanted the best in the country, he wanted the best in the world.
0:31:02 > 0:31:04He wanted the best for the people of Tredegar.
0:31:04 > 0:31:06'If it hadn't been for him,
0:31:06 > 0:31:10'Tredegar Medical Society wouldn't have been the society it eventually became.
0:31:10 > 0:31:14'My grandparents and my parents knew that if they fell ill,
0:31:14 > 0:31:16'they could just go along to the doctor
0:31:16 > 0:31:19'and the service was there, the help was there.
0:31:19 > 0:31:22'If my father had gone on the sick, he knew he would've had sick pay.
0:31:22 > 0:31:24'If my mother needed hospital treatment,
0:31:24 > 0:31:28'she knew that the local hospital would look after her needs.'
0:31:28 > 0:31:31And if they couldn't treat her in the local hospital,
0:31:31 > 0:31:34then the bus fare would be paid, to Newport, or Cardiff,
0:31:34 > 0:31:37or Bristol where she would get the treatment she required.
0:31:38 > 0:31:41Tredegar was also the birthplace of the Labour MP
0:31:41 > 0:31:44and future Health Minister, Aneurin Bevan.
0:31:45 > 0:31:49The Medical Aid Society would be a major influence
0:31:49 > 0:31:52in shaping his vision of a National Health Service.
0:32:03 > 0:32:08But in the 1930s, there were still enormous challenges to overcome.
0:32:12 > 0:32:14Despite the progress of the previous century,
0:32:14 > 0:32:17infectious diseases continued to claim
0:32:17 > 0:32:21the lives of thousands of people in Britain every year.
0:32:22 > 0:32:26Diphtheria was one of the worst.
0:32:26 > 0:32:28A highly contagious respiratory infection,
0:32:28 > 0:32:31one of its most frightening symptoms
0:32:31 > 0:32:34is the swelling of membranes in the throat,
0:32:34 > 0:32:37making breathing increasingly difficult.
0:32:40 > 0:32:45The disease had a profound effect on Betty Giltinan's family.
0:32:49 > 0:32:52'My mother contracted diphtheria'
0:32:52 > 0:32:57and...she was only 33.
0:32:59 > 0:33:01And she didn't survive.
0:33:04 > 0:33:07'I wasn't aware of the fact my mother was ill,
0:33:07 > 0:33:10'but I know that I had to go and live with my grandmother
0:33:10 > 0:33:15'for six weeks and then when I came back home,
0:33:15 > 0:33:17'after they'd fumigated the house',
0:33:17 > 0:33:21I knew mum was missing... and...
0:33:22 > 0:33:24..and that was it.
0:33:24 > 0:33:30'There was my sister, Peggy, and sister Enid
0:33:30 > 0:33:32'and brother Trevor'
0:33:33 > 0:33:39and there was the baby of five months and he was Hugh.
0:33:39 > 0:33:44'Dad realised that he couldn't cope with five.'
0:33:45 > 0:33:50Dad's brother, apparently his wife could not have a family
0:33:51 > 0:33:58and he came up to see my dad and begged him, could he take Hugh?
0:33:58 > 0:34:05And he was adopted, but, um...
0:34:05 > 0:34:08..it was never discussed, you know.
0:34:17 > 0:34:20Around the time, Betty's mother had died,
0:34:20 > 0:34:24mass immunisation trials were underway in Canada and America.
0:34:27 > 0:34:31By the early 30s, deaths in Canada had fallen sharply
0:34:31 > 0:34:36and in some cities, diphtheria had been eradicated altogether.
0:34:41 > 0:34:43Yet in Britain, little had changed.
0:34:43 > 0:34:48The disease was still responsible for a third of all childhood deaths.
0:34:52 > 0:34:56'Diphtheria immunisation in the 1930s
0:34:56 > 0:34:58'was a failure on a number of different levels.'
0:34:58 > 0:35:01Part of the problem was the dislocation between local
0:35:01 > 0:35:04and central health responsibilities in Britain.
0:35:04 > 0:35:08'Immunisations were a local government,
0:35:08 > 0:35:10'not a central government responsibility.'
0:35:10 > 0:35:13They're not receiving money from central government
0:35:13 > 0:35:15for immunisation programmes
0:35:15 > 0:35:20'and so they're very much at the mercy of the local town councils
0:35:20 > 0:35:25'as to whether they're going to find the funds to run vaccination,
0:35:25 > 0:35:30'immunisation campaigns and it's not seen as a priority',
0:35:30 > 0:35:36despite the fact that between two and 3,000 children are dying each year
0:35:36 > 0:35:40in Britain from diphtheria and those are quite unnecessary deaths.
0:35:44 > 0:35:47It would take until the Second World War for central government to act.
0:35:49 > 0:35:52Amid fears that cramped conditions in air raid shelters
0:35:52 > 0:35:55would lead to an epidemic,
0:35:55 > 0:35:58they finally introduced an immunisation programme.
0:35:58 > 0:36:03Within a decade, diphtheria would become a disease of the past.
0:36:09 > 0:36:12The country's approach to controlling infectious diseases
0:36:12 > 0:36:18was a legacy of the 19th century public health system.
0:36:20 > 0:36:24This was founded on the belief that local organisations
0:36:24 > 0:36:27were better placed to deal with health problems in their community
0:36:27 > 0:36:29than a central authority would be.
0:36:32 > 0:36:35As a result, public health departments were run
0:36:35 > 0:36:38and largely financed by local councils.
0:36:42 > 0:36:44And in the 1930s,
0:36:44 > 0:36:48they had more impact on the health of ordinary people than any doctor.
0:36:51 > 0:36:55And the person in charge was the Medical Officer of Health.
0:36:55 > 0:36:58'Medical officers of health'
0:36:58 > 0:37:02were THE most powerful local government officers.
0:37:02 > 0:37:06They ran enormous departments, they had incredible political clout.
0:37:06 > 0:37:10They were really the guardians,
0:37:10 > 0:37:13'not only of the health of the population,
0:37:13 > 0:37:18'but to some extent the economic health of their towns and cities.
0:37:18 > 0:37:21'They understand what causes ill-health'
0:37:21 > 0:37:24and sitting as they do in local government,
0:37:24 > 0:37:28they are in the most influential place that they can be.
0:37:34 > 0:37:38By the mid 1930s, public health departments were responsible
0:37:38 > 0:37:40for a huge range of services,
0:37:40 > 0:37:44with the emphasis firmly on the prevention of ill health.
0:37:48 > 0:37:50Street cleaning...
0:37:52 > 0:37:54..public laundries...
0:37:55 > 0:37:58..bath houses...
0:38:00 > 0:38:02..and maternity clinics.
0:38:06 > 0:38:08And in some cities like Liverpool,
0:38:08 > 0:38:11ambitious programmes of housing development.
0:38:14 > 0:38:18Working alongside them was another key department,
0:38:18 > 0:38:21the school medical inspections service.
0:38:21 > 0:38:26Its job was to monitor the health of the country's poorest children.
0:38:28 > 0:38:33In 1929, Stanley Jarvis joined the team at Liverpool.
0:38:36 > 0:38:38'My father was a kindly soul, he liked kids.
0:38:38 > 0:38:41'He always got on very well with kids
0:38:41 > 0:38:45'and he'd go round the schools and talk to the children and so forth.'
0:38:45 > 0:38:47In those days, all school children had their height and weight
0:38:47 > 0:38:50measured every term and they had a medical examination
0:38:50 > 0:38:53when they arrived at the school and before they left the school
0:38:53 > 0:38:56'and if a child, for example, lost weight during a term,
0:38:56 > 0:39:00'this was a cause for the Medical Officer of Health to look at them.'
0:39:02 > 0:39:06Improving children's health had been a priority
0:39:06 > 0:39:09since concerns were first raised about the nation's lack of fitness.
0:39:12 > 0:39:16The school Medical Inspection Service provided free treatment
0:39:16 > 0:39:19for the country's poorest children.
0:39:19 > 0:39:23If problems were picked up, children were referred to a clinic.
0:39:23 > 0:39:27Peter's father's was next to one of Liverpool's public wash houses.
0:39:28 > 0:39:31'I remember seeing a row of children sitting,
0:39:31 > 0:39:34'um, with bowls of hot water,
0:39:34 > 0:39:38with wooden spoons bound round with bandages,
0:39:38 > 0:39:41applying this wooden spoon as a hot fermentation to their sore eyes,
0:39:41 > 0:39:44because they had a stye.
0:39:44 > 0:39:47And there was one child I remember had both eyes swollen
0:39:47 > 0:39:51and looking back now I wonder if that child hadn't got acute nephritis.
0:39:51 > 0:39:56It's practically unheard of now but it was an infectious condition,
0:39:56 > 0:39:58you got a good old streptococcal infection
0:39:58 > 0:40:00and was it spread to your kidneys, jiggered your kidneys
0:40:00 > 0:40:03and you got these characteristic signs of nephritis
0:40:03 > 0:40:05and one of them was this very puffy pair of eyes.
0:40:05 > 0:40:08I haven't seen one of those in 40 years.
0:40:16 > 0:40:20But for some health problems, local solutions weren't easy to find.
0:40:23 > 0:40:26Heavy industry and coal fires polluted many of Britain's cities
0:40:26 > 0:40:30and provided the perfect recipe for poor health.
0:40:32 > 0:40:34'The buildings were black with soot',
0:40:34 > 0:40:38everything was black and when the wind wasn't blowing of course,
0:40:38 > 0:40:42this pall of smoke settled on the place and sat for miles around.
0:40:42 > 0:40:48It was a great dome-shaped hump of filth, covering the entire district.
0:40:48 > 0:40:53'It was hardly surprising I got bronchitis every winter.
0:40:55 > 0:40:59'And when I got bronchitis, they would put kaolin poultices on my chest
0:40:59 > 0:41:02'front and back. This was a large acreage of fuzzy felt stuff'
0:41:02 > 0:41:05and you covered it with hot kaolin
0:41:05 > 0:41:09and slapped it on just, not quite hot enough to burn you,
0:41:09 > 0:41:11but it went cold in about five minutes
0:41:11 > 0:41:13and very clammy and disgusting.
0:41:13 > 0:41:16I didn't like this and I said so and I was told,
0:41:16 > 0:41:19"Nonsense, boy. Don't argue, it will do you good."
0:41:19 > 0:41:22But I never did think it did and I still don't think it did.
0:41:25 > 0:41:28These polluters of environments contributed to another condition
0:41:28 > 0:41:32that affected the health of the country's poorest citizens...
0:41:33 > 0:41:34..rickets.
0:41:34 > 0:41:39Many who worked in public health were determined to find a cure.
0:41:41 > 0:41:45"Rickets is principally a children's disease.
0:41:45 > 0:41:48"The growing bones don't form properly.
0:41:48 > 0:41:50"These x-rays show what has happened.
0:41:50 > 0:41:52"On the right is a normal child's knee.
0:41:52 > 0:41:55"On the left is his other knee before he was cured of rickets."
0:41:58 > 0:42:00Rickets is caused by a lack of vitamin D
0:42:00 > 0:42:03and is prevented by exposure to sunlight
0:42:05 > 0:42:10and a diet rich in calcium-producing foods like milk, eggs, or fish.
0:42:13 > 0:42:16Some public health departments offered sunlight treatment
0:42:16 > 0:42:21to families whose diet and living conditions made them particularly vulnerable.
0:42:26 > 0:42:29Brenda Watkinson's family was one of those who benefited.
0:42:31 > 0:42:37My mother, when she was born in 1901, suffered from rickets from malnutrition
0:42:37 > 0:42:40and was actually in leg irons in her early years.
0:42:40 > 0:42:45When my brother was born, like my mother, he was very under nourished.
0:42:45 > 0:42:48I think he would be probably not a lot older than five.
0:42:49 > 0:42:54He had sunlight treatment, also for the malnutrition.
0:42:54 > 0:42:57It was reckoned to build children up.
0:42:57 > 0:43:00He gradually got better.
0:43:00 > 0:43:02But he was very thin.
0:43:04 > 0:43:09The link between vitamin D and rickets was discovered by the scientist, Edward Mellanby.
0:43:11 > 0:43:13Seen here in home movies.
0:43:16 > 0:43:19He argued that a good diet was essential to health
0:43:19 > 0:43:24and advocated giving free supplements of cod liver oil to all children.
0:43:43 > 0:43:45Mellanby was one of a group of scientists
0:43:45 > 0:43:49whose work would have social and political implications.
0:43:50 > 0:43:52The 1930s was a period
0:43:52 > 0:43:57in which the science and nutrition was making great strides.
0:43:57 > 0:44:01Investigators were getting a much better understanding
0:44:01 > 0:44:04of the bio-chemistry of nutrition.
0:44:04 > 0:44:09That was leading them to draw conclusions about the minimum income
0:44:09 > 0:44:14that would be necessary to purchase a diet for healthy living.
0:44:14 > 0:44:20What that led onto in turn, was actually a critique of government policy.
0:44:22 > 0:44:25And the scientists weren't the only ones campaigning for change.
0:44:25 > 0:44:29A growing number of voices from the political left,
0:44:29 > 0:44:33to social reformers and public health officials, were calling on the government
0:44:33 > 0:44:39to do more to prevent the problems of ill health that stemmed from poverty.
0:44:40 > 0:44:43This film was part of that campaign.
0:44:43 > 0:44:46There is a marked difference in the heights of boys
0:44:46 > 0:44:49drawn from different classes of society.
0:44:49 > 0:44:52At 13 years of age, the boys at Christ's Hospital School
0:44:52 > 0:44:57are, on average, nearly two-and-a-half inches taller than those from council schools.
0:44:57 > 0:45:02At 17, they're nearly four inches taller than working boys of the same age.
0:45:03 > 0:45:07These differences are largely due to differences between the food they eat.
0:45:09 > 0:45:14The film shows how the general health of the population was fairing.
0:45:14 > 0:45:18It features the work of a leading campaigner, Dr George McGonigle,
0:45:18 > 0:45:22then Medical Officer For Health for Stockton upon Tees.
0:45:23 > 0:45:28He looked specifically at how income affected the diet of families in his area.
0:45:29 > 0:45:33Now I've been finding out in my own district,
0:45:33 > 0:45:36how much the average housewife has to spend
0:45:36 > 0:45:40and what she spends it on, right down to the last penny.
0:45:40 > 0:45:46He had two case studies in Stockton Upon Tees,
0:45:46 > 0:45:49and he could show the difference between the diets
0:45:49 > 0:45:51and the living conditions in these two areas.
0:45:51 > 0:45:56It was certainly income that had the biggest effect on health.
0:45:56 > 0:46:01What he did was to calculate whether people could afford
0:46:01 > 0:46:05adequate diets for health on the rates of unemployment benefit
0:46:05 > 0:46:08that they were receiving from the government.
0:46:08 > 0:46:14The evidence that McGonigle found was that, no, unemployment benefits were not adequate for health.
0:46:17 > 0:46:20McGonigle became an increasingly controversial figure,
0:46:20 > 0:46:25with his calls for the government to increase welfare benefits.
0:46:26 > 0:46:29He took on a very political role
0:46:29 > 0:46:34and public health has always been political from the 1840s to the present day.
0:46:34 > 0:46:39He saw his primary responsibility as one of advocacy.
0:46:39 > 0:46:45Knowing what was wrong with his population and knowing what should be done to put it right
0:46:45 > 0:46:47and he came into direct conflict.
0:46:47 > 0:46:52As a result of this, he was threatened with disciplinary proceedings
0:46:52 > 0:46:54by the General Medical Council.
0:46:56 > 0:47:00The government resisted McGonigle's calls to increase benefits
0:47:00 > 0:47:04but his campaign had huge popular support and he kept his job.
0:47:05 > 0:47:11And the focus from people like McGonigle on ways to improve people's health
0:47:11 > 0:47:14also helped generate new approaches to preventative medicine.
0:47:16 > 0:47:21One of these was a radical experiment based in Peckham, in south London.
0:47:23 > 0:47:26It attracted enormous interest at the time.
0:47:26 > 0:47:30This film was made to showcase its work.
0:47:30 > 0:47:34Almost at the foot of Big Ben, you can catch a number 35 tram.
0:47:34 > 0:47:38After about half an hour, through factories and crowded streets,
0:47:38 > 0:47:40you come to Peckham.
0:47:40 > 0:47:44Here you will find the Centre, The Pioneer Health Centre.
0:47:46 > 0:47:51As with McGonigle's work, the experiment set out to discover the factors,
0:47:51 > 0:47:54which influenced people's health and centred particularly
0:47:54 > 0:47:57on the significance of family relationships.
0:48:00 > 0:48:03That's my father.
0:48:03 > 0:48:06He was compering, as he would
0:48:06 > 0:48:10on a Saturday evening, with a dance that was going on.
0:48:10 > 0:48:15# Let us dance a Centre waltz together
0:48:17 > 0:48:21# Always smile and never mind the rain... #
0:48:21 > 0:48:24Pam Elven's family was one of the first 200
0:48:24 > 0:48:29who joined the Pioneer Health Centre when it opened in 1935.
0:48:31 > 0:48:32They took me one afternoon
0:48:32 > 0:48:38and I was over-awed, I think, would be the words I'd use,
0:48:38 > 0:48:40of seeing this magical place
0:48:40 > 0:48:43and it changed my life.
0:48:45 > 0:48:49Membership was by subscription and open to families in employment,
0:48:49 > 0:48:52who lived within pram-pushing distance of the Centre.
0:48:53 > 0:48:57The way the Peckham Centre was planned was as a scientific experiment
0:48:57 > 0:49:01and what they did was to set out a series of buildings,
0:49:01 > 0:49:04centred really around a social club
0:49:04 > 0:49:06where people would be attracted into the Centre.
0:49:06 > 0:49:11There they could be examined, monitored and surveyed.
0:49:11 > 0:49:13An old fashioned Big Brother, if you like.
0:49:17 > 0:49:20The idea came from two biologists,
0:49:20 > 0:49:23Innes Pearse and George Scott Williamson.
0:49:23 > 0:49:28And what we are trying to do is to study health.
0:49:28 > 0:49:30Find out what health is.
0:49:30 > 0:49:34And strangely enough, it's the first time it's ever been tackled.
0:49:37 > 0:49:40Scott Williamson wanted to test his theory that by creating
0:49:40 > 0:49:43the right environment, you could also create the right conditions
0:49:43 > 0:49:48for the development of good health, in mind and body.
0:49:51 > 0:49:56When people joined the Centre, they were subjected to three examinations.
0:49:56 > 0:50:01There was a physical examination, the usual medical examination, of the body,
0:50:01 > 0:50:05but also part of it was a consultation with the family.
0:50:05 > 0:50:09In the 19th century medicine was interested in single, separate bodies.
0:50:09 > 0:50:13So a family of five people would be five separate bodies.
0:50:13 > 0:50:18What Peckham introduced was this idea that the interaction between these people
0:50:18 > 0:50:22could tell you something about their health, about their lifestyle,
0:50:22 > 0:50:25about how they were going on in their lives.
0:50:25 > 0:50:28So the scientists explored their relationships.
0:50:30 > 0:50:35The members are co-operating in a unique piece of research into social biology.
0:50:37 > 0:50:39We were guinea pigs.
0:50:39 > 0:50:41It wasn't just me, we were all guinea pigs.
0:50:41 > 0:50:45It was a complete contrast to what we were used to.
0:50:45 > 0:50:47I loved it.
0:50:47 > 0:50:53I had children to play with, I could do things on my own.
0:50:53 > 0:50:55I mean, my mother didn't know anybody,
0:50:55 > 0:50:59she didn't know the people on the opposite side of the road.
0:50:59 > 0:51:04It wasn't until she joined the Centre that she made friends.
0:51:04 > 0:51:08One of the families that they met there was Doreen Head's.
0:51:08 > 0:51:12I liked swimming, so I learnt to swim down there.
0:51:12 > 0:51:17My younger brother, he was quite young, he went into nursery.
0:51:17 > 0:51:20My other brother, he liked badminton.
0:51:20 > 0:51:24He was always on the badminton court in the gymnasium and that.
0:51:24 > 0:51:26Then my sister, she was that little bit older,
0:51:26 > 0:51:31she was able to take advantage of the dances on a Saturday evening.
0:51:32 > 0:51:38Within two years, over 650 families had joined the Centre
0:51:38 > 0:51:40and a picture of their health began to emerge.
0:51:41 > 0:51:45When the Peckham doctors examined patients
0:51:45 > 0:51:49they found that 93% could be identified as having some sort of abnormality.
0:51:49 > 0:51:52That means 7% were truly healthy.
0:51:55 > 0:51:59Williamson and Pearse published their findings in 1943.
0:51:59 > 0:52:06Many of the children were found to have worms, deformed toes and decayed teeth.
0:52:08 > 0:52:12I'd previously broken my arm and they were very interested in this.
0:52:12 > 0:52:15They kept looking at the arm, to see how it was
0:52:15 > 0:52:21and when it came out of the plaster they were giving me exercises.
0:52:23 > 0:52:26Amongst the adults there were more serious problems.
0:52:27 > 0:52:32Most of the women were anaemic, some had high blood pressure,
0:52:32 > 0:52:35kidney disorders and cancer.
0:52:35 > 0:52:39All examinations, and all the monitoring was only concerned
0:52:39 > 0:52:43with recording these things. There was no treatment.
0:52:43 > 0:52:44They were said to be advisory.
0:52:44 > 0:52:47So, if they did find anything really serious, medically,
0:52:47 > 0:52:49they advised the patient to go elsewhere.
0:52:51 > 0:52:54They discovered there was a lot wrong with me.
0:52:54 > 0:52:57I was anaemic for one, I was deaf for another.
0:52:57 > 0:53:00I seemed to have a lot of rheumatism.
0:53:02 > 0:53:07The doctor that we had at the time said, "It's only growing pains, mother."
0:53:07 > 0:53:10They discovered that I had rheumatism.
0:53:10 > 0:53:15How did they know? They sent me off to one of the hospitals in London,
0:53:15 > 0:53:20where I had some tests done. I was a sickly child,
0:53:20 > 0:53:26but my mother reckons she saw me grow into a very healthy child,
0:53:26 > 0:53:29within perhaps 18 months of being there.
0:53:37 > 0:53:41The Centre doctors also believed in the importance of good food
0:53:41 > 0:53:44and this farm was opened in Kent.
0:53:51 > 0:53:55Here, the families helped with the crops and used it for weekend camps.
0:54:06 > 0:54:10Life for people like Pam had come to revolve around the Centre.
0:54:14 > 0:54:15Mixing with other people,
0:54:15 > 0:54:19we were enjoying life with a lot of other people.
0:54:21 > 0:54:24It was probably the best years of my life.
0:54:27 > 0:54:30The outbreak of the Second World War in 1939
0:54:30 > 0:54:33brought a temporary halt to the Peckham Experiment
0:54:33 > 0:54:37but it was also the trigger for wider discussion
0:54:37 > 0:54:40about health reform on a grand scale.
0:54:40 > 0:54:47From this point onwards, the British state asked its citizens to make various sacrifices,
0:54:47 > 0:54:49both on the battlefield and on the homefront and
0:54:49 > 0:54:55in return had to offer the prospect of a better society in the post-war world.
0:54:55 > 0:54:59So what you see during the war years is a great many plans being formulated,
0:54:59 > 0:55:03a growing pressure and opinion in favour of substantial social reform,
0:55:03 > 0:55:08including reform in the area of medical care and services.
0:55:09 > 0:55:12The future...
0:55:15 > 0:55:19And the vision of the future for Britain's health services
0:55:19 > 0:55:26came from Aneurin Bevan, Minister Of Health in the Labour government of 1945.
0:55:26 > 0:55:30It was a vision in which the Medical Aid Society in Bevan's hometown of Tredegar
0:55:30 > 0:55:32had played a key part.
0:55:32 > 0:55:36Their example of comprehensive health care
0:55:36 > 0:55:39showed how a national system could work.
0:55:40 > 0:55:44But the new NHS would be controlled by central government
0:55:44 > 0:55:46and there was no room for local initiatives.
0:55:48 > 0:55:50With the formation of the NHS,
0:55:50 > 0:55:53the board from the Medical Aid Society went to Bevan
0:55:53 > 0:55:55and pleaded for a special case to be made
0:55:55 > 0:55:58on the Tredegar Medical Aid Society.
0:55:58 > 0:56:01At that time, Bevan actually turned to the Board and said,
0:56:01 > 0:56:06told them, that basically they were a victim of their own success.
0:56:06 > 0:56:10That was the end of the Tredegar Medical Aid Society as we knew it.
0:56:13 > 0:56:16The Peckham Centre faced a similar fate.
0:56:16 > 0:56:19It had reopened after the Second World War
0:56:19 > 0:56:23and members like Pam Elven and her fiance, Adge,
0:56:23 > 0:56:26were completely unprepared for life without it.
0:56:30 > 0:56:33The first we knew, all of us knew,
0:56:33 > 0:56:35was a notice that went up on the notice board
0:56:35 > 0:56:39to say that the Centre was going to close that Saturday.
0:56:39 > 0:56:41We just couldn't believe it.
0:56:42 > 0:56:44It was like a death knell.
0:56:44 > 0:56:48We were going around silent, as if someone had died.
0:56:49 > 0:56:51People were weeping, you know.
0:56:51 > 0:56:55Shaking their heads, "What are we going to do without the Centre?"
0:56:55 > 0:56:59It affected everybody from children to grandparents.
0:57:03 > 0:57:05The experiment was over.
0:57:06 > 0:57:11But the Peckham doctors' focus on good health, and the factors, which contributed to it,
0:57:11 > 0:57:14would eventually find a place in modern medicine.
0:57:18 > 0:57:22It formed a blueprint for what could happen later in the century.
0:57:22 > 0:57:25There's a new idea comes into medicine, risk factors,
0:57:25 > 0:57:28and we all have risk factors, in terms of the food we eat,
0:57:28 > 0:57:31and the exercise we take and the lifestyles we have.
0:57:31 > 0:57:35And those risk factors which now dominate our thinking about health,
0:57:35 > 0:57:38were first laid down in the Peckham Experiment.
0:57:43 > 0:57:47When the National Health Service began in 1948,
0:57:47 > 0:57:51it brought order to the chaos of previous decades,
0:57:51 > 0:57:55and recognised for the first time that access to health care
0:57:55 > 0:57:59should not be dependent on individual circumstances.
0:58:02 > 0:58:08The new system wasn't perfect, but it did ensure that when people were sick
0:58:08 > 0:58:11there was no barrier to seeing a doctor and being treated.
0:58:13 > 0:58:18And from now on, the health of the nation would be linked inextricably,
0:58:18 > 0:58:21to the health of all its citizens.
0:58:52 > 0:58:55Subtitles by Red Bee Media Ltd