The Nature of Health

Reflections on the Peckham Experiment
by Mary Langman, M.B.E. more about Mary Langman

(Mary was a member of staff and later ran Oakley House farm)

"I shall try to give a glimpse of the implications of something that happened fifty years ago, and hope that this whets your appetite to explore the books written about it - for they are still in print.

You have to realise that the seedbed for what happened was a different world - the privations of the early years of the century with all their consequences for health. Public figures had become concerned, for example, at hw few candidates for military service were fit enough to undertake it. (This is sadly still relevant today, and in the last 20 years fitness tests for entry into the Armed Forces have been reduced in intensity.)

George Scott Williamson was pathologist at the Royal Free Hospital and lecturer on pathology at the associated School of Medicine for Women. There, and at the Royal College of Surgeons he conducted research on the structure and function of the thyroid gland, publishing many papers. Innes Hope Pearse was a student of his and became his research assistant and eventually his partner. With a group of non-medical supporters who shared their concern with the prevention of disease, they set up a small scale experiment in a dwelling house in Peckham - the pioneer health centre. This was a social club with a family membership, providing nursery facilities and a medical check-up. Any abnormalities the doctors found were referred to one of their excellent range of specialist contacts.

Within a few years Scott Williamson shut this venture down; it had become apparent that whatever abnormalities they found were returning in some form even where they had been successfully treated, on return to the same environment as had caused them in the first place.

Something had to be done about that; but what? The doctors could have no control over the working environment, not over the facilities at home. They had little influence over conditions is schools. Their only point of leverage was small - the limited leisure time available to everyone at various time of their day.

Scott Williamson and his associates began to plan the first purpose-built leisure centre, but it became a much richer resource than we are used to today. It was planned to serve the same local district in Peckham, and to attract a membership of up to 2000 families - within easy pram pushing distance, yet large enough to cater for a wide variety of talents and interests. Membership was by family - so that children, keen to join, sometimes had to persuade their more diffident parents too.

The real genius, however, was in the design of the building itself. Everything going on was made visible to all in the building, centred round the full-size swimming pool. It had been foreseen that the sight of action would be the stimulus to action - and this indeed proved to be so. All the spaces - whether used by infants and young children or for the activities of adults - were flexible and available for various uses at different times of day. One of the staff, Lucy Crocker, devised a ticketing scheme which provided the minimum necessary regulation of access to different activities yet enabled the 'curators' to keep track of what people did and how they developed.

For the doctors - biologists as they saw themselves - principal interest was in research. One of the few conditions of membership was that families underwent a medical overhaul each year. The content and object of the overhaul soon evolved; from attention to the detection of disease at an early stage, the focus changed to departures from health, and ultimately to assessment of the quality of health itself - a true health overhaul.

This took place within the family circle, where the findings of overhaul were given in the setting of a family consultation. Advice was not offered - for unsought advice is rightly resented - but information. As a member put it when introducing a new family to the Centre - 'The doctor tells you where you stand'. Imparted with skill, such information can also afford a glimpse of 'where you could reach to'. In the Centre, doctors and members had at their disposal a rich variety of 'prescriptions' - exercise, crafts, artistic pursuits, congenial company and better quality food which was brought up daily from the Centre farm at Bromley Common.

For many members, as for the staff, this provided an intense experience, compressed into two periods of four years each leading up to and immediately following the second war. For me what was particularly exciting was the emphasis on cultivating what was right - as distinct from providing remedies for what was wrong. ~The same emphasis inspired the staff involved in overhauls, and the 'curators' working on the social floor - and came to be appreciated by the member-families themselves.

The Centre closed in 1950 through post-war inflation and lack of political will: it was an embarrassment to the architects of the National Health Service, which took an overwhelmingly medical direction - with no concern at all for the cultivation of health. But there has been time to reflect on the experience and to draw many lessons from it.

In the first place, since disease and disorder are so prevalent, if you want to study health you have to cultivate it. The spontaneous formation of the family nucleus and the growth of its individual members can then be witnessed through the events of healthy pregnancies progressing to infancy in the nursery setting. Young people can be observed and known as they couple up and prepare themselves consciously for parenthood. In Peckham we began to see 'bespoke babies', conceived, born and nurtured in the best conditions available, babies who seemed to know intuitively and confidently how to grow up. It became possible to think in terms of real fulfilment of potential.

From those who watched the babies - parents, staff and visitors alike - the comment - 'Centre babies are different' - came so often as to become almost commonplace. How to describe that so evident difference - and in terms of criteria recognised in science, was a research challenge.

It must be stated that everything was measured and recorded that could be in those days, both for the parents and for the babies, and that the Centre had its own laboratories. But no quantitative measure wholly captured the manifest difference: there was, for example, no means of measuring the serenity, or the individual patterns of response in such babies. So Scott Williamson was led to introduce an entirely separate notion of quality, as a factor that cannot be measured analytically though it may be appreciated aesthetically - and whose influence can be supremely potent in action.

He developed this concept in his treatise 'Science, Synthesis and Sanity' which was completed and published after his death by his colleague Innes Hope Pearse. This is a major work which one say should come into its own, as a seminal attempt to define health and the quality of life.

In one highly condensed sentence he defined health as of 'the faculty for mutual synthesis of organism and environment'. Each of these terms is extensively defined and discussed in the book.

So we have to take quality into account in a study of health. When we do so, said Scott Williamson, we come to see that in the living entity health can only be seen as a process - not as a state or condition.

Modern society has not yet caught up with such concepts. One must hope to see their further exploration and development in science, and of the implications for philosophy. But for those of us most concerned with the wellbeing of our society - and with the health of future generations - the Peckham experience has a clear message. It is that health is more infectious than disease, given the right conditions for its spread. The Peckham experiment offers some guidelines as to what those conditions may be. It must be for each generation to work out the detail of their application in the circumstances of its own time."