For many of us our memories of healthcare begin in childhood. From visits to the GP and vaccinations, to eye tests and dental check-ups, most of us have engaged with the NHS at a young age. Some children spend a considerable amount of time in hospital, engaging in the NHS in different ways to their peers, with the hospital becoming a location not just of prevention or treatment, but also of in-patient care. This photo, which we chose as the banner image for the People’s History of the NHS website, depicts such in-patient care in 1953 and within the newly formed NHS.
Showing children on a ward at Bow Arrow Hospital in Dartford, a specialist facility for treating tuberculosis, this photo prompts us to think about the place of children, childhood and the visual presence of the hospital within the cultural history of the NHS. It also allows us to consider the role that infectious disease, especially within childhood, plays in this history. This photo was taken at a time when tuberculosis as a widespread health problem was waning. A BCG vaccination scheme to prevent tuberculosis was introduced into the British schedule in 1953 for school leaving children (age 14), the same year that this photo was taken. Therefore this photo was taken on the eve of vaccination.
Yet, this image does not convey a public health story, the triumph of vaccination over the long scourge of tuberculosis. Instead, it emphasises the space of the hospital and the positioning of children within that space. The communal ward with beds and toys intermingled and the image of children alongside nurses but not parents represents a particular time within NHS care of children in hospital. Up until the late 1940s, it was widely accepted that it was undesirable for children to be visited regularly by their parents in hospital. Many hospitals permitted only monthly visitations and some not at all. During the 1950s however, there was growing concern about leaving young children in hospital apart from their parents and the threat of ‘separation anxiety’. This related to psychological theories about the importance of attachment. This slowly led to changes to make it easier for parents to visit children although it wasn’t until the 1970s that unrestricted visiting became standard policy in NHS hospitals.
From an historical perspective this image provides insight into the world of the hospital at a time when regular parental visitation was almost non-existent. It also points to ways that changes in disease impacted upon hospital provision and hospital spaces – there would be much less need for such childrens’ sanatoria in future and therefore, separating children from both society and their parents would become increasingly unnecessary.
Therefore, this is not a typical photo of childhood hospital care within the NHS. Yet it points to a particular type of care for children. The image emphasises the place of children at play, in part by centring the lovely mini merry-go-round, within their hospital stay. While bed rest was an important component of tuberculosis treatment plans throughout the 1940s and 1950s, this ward emphasises the place of play alongside rest to the recovery of these children. The piano and tables in the middle of the room similarly construct play and interaction between the children patients as an element of daily ward life. But it is also interesting to reflect on what this picture may tell us about the style of care given at Bow Arrow Hospital. It is both precisely ordered, with the beds perfectly made up even with their children occupants still in place. Yet the room is also child-friendly. It includes children’s toys, pictures on the walls and childhood interaction, which as a symbol of care emphasises committed nursing staff and their role in facilitating interpersonal interactions on behalf of the children patients.
The large, open windows and the airy, uncluttered atmosphere of the ward itself were partly about the focus on fresh air, light and exercise for treating tuberculosis. The high ceilings of the Victorian hospital were thus refashioned as important curative tools and visually linked to an ordered regimen. While later, these buildings came to be seen as cold, damp and unsuitable for modern, high-tech care, they remain important visual reminders in the British landscape of the former hospital site, where many personal encounters with the NHS were first forged. Although this photo shows us the interior of one specific hospital, it serves to touch on many of the themes, topics and interactions that we are looking to uncover through the People’s History of the NHS website.
While Bow Arrow Hospital no longer exists, with the building itself knocked down to make way for a housing estate, this image provides a wider snapshot of the place of the child within the early years of the NHS. It shows how the different needs of children, particularly their need to play, were facilitated and incorporated into the everyday life of the children’s ward. As such it allows us to consider the place of childhood illness within the cultural history of the NHS as well as the important location that the hospital has played, and continues to play, in providing care within a community.
We see this image as one way to spark a new conversation about the cultural significance of the NHS. We hope that it helps you remember or think about what your interactions with the NHS have meant to you, both in childhood and adulthood. We’d love to hear your recollections of time spent on children’s wards, as children, as parents and as nurses or doctors.
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