The Finsbury Health Centre’s origins are based in municipal efforts to improve living conditions on the Northampton Estate, which owned much of Clerkenwell, London. The first stage was the building of the Pine Street Maternity Centre – opened 1927 on land donated by the Marquis of Northampton. Its purpose was to afford advice and assistance to expectant and nursing mothers and to protect and foster the child life of the borough. Services provided included Sun-ray treatment for children, even an Italian mothers clinic.
The slum courts next to the maternity centre were earmarked for clearance and redevelopment and various schemes involving housing and healthcare were discussed between the Finsbury Borough Council (1934, Labour), London County Council and the land’s owner, the Marquess of Northampton.
Finsbury was not unlike many other inner London boroughs in terms of poverty and overcrowding. What made Finsbury different was a devout Socialist leader – Alderman Harold Riley.
Provisions under the Public Health (London) Act 1936 enabled local councils to provide medical service for poorer inhabitants. In taking up these provisions Finsbury Council accepted responsibility for local health.
Riley’s enthusiasm backed by that of Dr Chuni Lal Katial, chairman of the public health committee and probably the driving force behind FHCs creation. He proposed a rationalised and standardised health service, bringing together the borough’s scattered services.
Katial, originally from the Punjab had only recently moved to Finsbury. He came to London in about 1929 and ran a medical practice in Canning Town. While there in 1931 he introduced a visiting Ghandi to Charlie Chaplin!
Katial saw plans for a never realised TB clinic for East Ham at the BMA Congress in November 1932 and liked what he saw. These plans, devised by an architectural firm named Tecton, became the basis for a new health centre for Finsbury – its aim; to improve Finsbury’s health services through centralisation.
At the opening Katial spoke of the Centre as a realisation of his vision:
“For some time the disadvantages of a service which has grown up piecemeal, retarded in its development and scattered here and there through lack of accommodation, have been only too apparent to my council.
Fully appreciating these difficulties, and actuated by a desire vastly to improve existing facilities and to establish new services, we have unanimously gone forward to erect this new health centre.
Its opening marks…the dawn of a new era in public health service”
Katial approached Tecton directly and instructed them to plan a centre based on the latest research with the prime focus being services.
It was a building there was no precedent for, and was the first Modernist design ever commissioned by a public client with a political constituency.
In 1936 Tecton presented 4 design options. The costliest option was chosen for its higher storeys and better quality finishes. The estimated cost was £55,000, but difficulties on the build saw the total cost including equipment rise to nearly £62,000.
Purchase of the site from the Marquess of Northampton was completed early in 1937, followed by the swift demolition of the existing buildings which included 21 houses, a firewood storage yard, a vacant drill hall, a grocers, a dairy, a wood and oil shop and a storage place for coster’s barrows.
Tecton’s lead architect and the man behind the FHC was an émigré from Communist Russia, one Berthold Lubetkin.
He also shared the view that art, including architecture could be used to make a political point. Lubetkin’s much publicised attitude was “Nothing is too good for ordinary people.”
Lubetkin was born in 1901 in Tiflis, Georgia. As an art student in Moscow he watched the 1917 revolution unfold before his eyes and the progressive politics and avant-garde art of the revolution were to influence him greatly.
In the FHC the aesthetics of Revolutionary Constructivism meet principles of social welfare.
Lubetkin’s view: “These are the primary objects of modern architecture; to improve by all means at the disposal of technique the living conditions of the people, and to create a language of architectural forms, which, being firmly based on the aesthetics of our age, conveys the optimistic message of our time – the century of the common man.”
Lubetkin had conceived his Centre like an informal open-access club, to encourage public to use services by making them feel comfortable using them. They can just “drop-in”. Lubetkin later said: “The centre’s opening arms and entrance were a deliberate attempt to introduce a smile into what is a machine.”
The original colour scheme for the entrance hall was red for the columns, sky blue for the ceilings and chocolate-brown for the floors. The impact must have been huge on a public that were used to pretty poor and drab services – if they could afford them they must be rubbish. The new health centre embodied Lubetkin’s principle that ‘Nothing is too good for ordinary people.’
Offices and clinics were placed in wings, angled to allow as much daylight in as possible. To maximise flexibility of space clinics were given moveable partition walls and all ducting placed behind panels on the building’s exterior. There was soundproofing between floors.
The concrete construction was devised in collaboration with Ove Arup, genius concrete engineer who was to work a lot with Tecton. He went on to design and engineer other concrete icons, the most famous being Sydney Opera House.
Design also reflected the prevailing ideas in medicine as requested by Katial and Dunscombe. For example, the therapeutic properties thought to be in light and air manifest in Lubs use of glass bricks and open planning for the interior.
The introduction to services in the opening booklet makes the point:
“Care has been taken to give to the whole structure a light and clean appearance, to make it an edifice to the splendid service it represents; a building which will inspire confidence through its thoroughly modern and up to date appearance.”
Other didactic and instructional element included in the design: murals by Gordon Cullen telling visitors to “Live out of doors as much as you can” and “Fresh air night and day” healthy living mural from Christian Herald. These were to encourage the people of Finsbury to also take ownership of their own health outside what the medical centre could offer – to ventilate rooms and let the light in. In many examples of poorer Finsbury tenements occupants would actually block fireplaces with rags to prevent drafts – the result; a fire that couldn’t be used and a blockage to the freeflow of air.
So, the centre was a clinic, a health club and conveyor of knowledge meant to encourage an interactive relationship between health providers and recipients. In order for health policy to work you need the intelligent cooperation of the community you serve.
Health Centre open for business
World War II was to ensure Lubetkin’s dream was never fully realised. The centre wasn’t itself bombed, but the threat of bombardment saw sandbags piled high around it from pretty much the day the building was finished. The result was that many of the glass bricks cracked under the weight.
The centre was turned into a bandaging centre for civilian casualties.
Heating ducts and plumbing were transferred inside the building which altered one of Lubs guiding principles. It was while the centre was serving as a first aid station that the Wonderful Cullen mural was whitewashed over. 45 It is still there however, under god knows how many layers of magnolia, so a possible candidate for future restoration. Lub was always to regret his socialist masterpiece being so altered by the events of WWII. In fact he refused to visit the centre for over 40 years because he was so angry with the council for altering his design and not consulting with him over refurbishment.
Finsbury became a symbol for modern healthy thinking and progress. Manifest in the 1943 Abram Games “Your Britain, fight for it now!” poster showing this Modern post-war phoenix rising from ashes of pre-war slums.
Incidentally, Churchill banned the poster. He said it was a “Disgraceful libel on the conditions prevailing in Great Britain before the war… the soldiers know their homes aren’t like that”. It may be this lack of recognition of the poor conditions returning heroes were returning to that cost him the next election in favour of the Labour Attlee government. Basically, the soldiers knew their homes were slums and wanted someone in government who recognised this and was geared up for change.
After the war the Finsbury Health Centre was seen as an exemplar of health provision. In 1946 the Islington Communist Party Pictorial reports “Our neighbour borough points the way – FINSBURY HEALTH CENTRE.” The report talks of all Islington Hospitals the same as Archway Hospital – dirty, noisy and overcrowded. But, they’ve seen a beautiful vision:
“A health centre in the middle of green lawns and flower beds. Modern, well ventilated buildings. We wait in a cheery waiting room, with a fire, and flowers on the table.
Soon we are shown to our own doctor. He is no longer overworked and harassed. A clerical staff looks after his records. His sole job is to cure us”
When the National Health Service was first formed in 1948, the Atlee government looked to the Finsbury Health Centre as a model for the delivery of public health care. Unfortunately money was short after the war and these plans were never realised.
Modern neglect and the attempts to restore
Even in the early 50s the health centre was recognised as a rare modernist masterpiece and seen as a prototype of best practice for future city building. It did not fit in with its surroundings, but in the 50s that was thought to be a problem with the surroundings, not the building!
In 1970 the Centre was listed as a building of special architectural interest and was later awarded Grade 1 listed status.
In 1982 the interior was refurbished by Watkins Gray Woodgate. By this time many of the original services had gone eg the reception house had become a vasectomy and alcohol abuse clinic.
In 1988, on the centre’s 50th anniversary, Islington Health District commission Avanti Architects review exterior for restoration. They were chosen because John Allan of Avanti actually knew Lubetkin and had worked on the restoration of Lubetkin’s London Zoo penguin pool. His report spotted lots of corrosion in external columns, canopies, planters, parapets and retaining walls – basically all external concrete surfaces required treatment. Exterior tiling was cracked or missing.
All the original glass blocks had been replaced over time with larger blocks. All the window frames are still the metal originals but all severely corroded. All of the thermolux (sheets of insulated glass) panels had been replaced – many cracked due to sandbagging. Many replaced straight after the war with asbestos concrete panels. The cost of restoration was estimated then at £1.2 million. Allan was only given £350,000 and did some good restoration on one part of the structure, but it just made what hadn’t been restored look worse!
(Based on notes made by Martin Banham, former manager of the Islington Local Studies Centre, 2008)
From 2002, with money earmarked for the Finsbury Health Centre under the government’s LIFT programme for building and upgrading health facilities, Islington Primary Care Trust worked with architects, medical staff, consultants, English Heritage and the 20th Century Society to come up with a plan to update and refurbish the building. As of Autumn 2007 the technicalities for the upgrade had seemed to have been worked out between all parties, when in March 2008 the PCT announced suddenly that the only option was to sell the building. This press release was hardly noticed, but in August 2008 Tom Foot began a series of articles in Islington Tribune about the coming 70th anniversary of Finsbury Health Centre and its planned closure. On 18 August a petition was started to stop a sell-off of Finsbury Health Centre and removal of its services by Barbara Jacobson, Helen Cagnoni and Barbara Heinzen, all local residents and patients at Finsbury Health Centre.
The petition was handed in to Alan Johnson on 14 January 2009 with over 1846 signatures, and elicited a letter from Ben Bradshaw, Minister for Health Services which merely repeated the PCT’s line. On 29 January the PCT (now NHS Islington) agreed to move the services from Finsbury Health Centre and sell the building. On 12 February Islington Council’s Health and Wellbeing Review Committee decided that there were problems with the consultation and voted unanimously to refer the fate of the centre to the Department of Health. The Independent Reconfiguration Panel’s recommendation to the DoH was submitted on 19 April.
Following these recommendations, on 19 May Alan Johnson, then Secretary of State for Health, released a letter which called for a local ‘process’ to decide the fate of the building, to include ‘local stakeholders’ as well as Islington Council and PCT. The PCT was criticised for lack of clarity about the patient need case for their proposed movement of services and about the transport impact on patients. There is still the possibility of the matter returning to the Independent Review Panel for a public inquiry if this ‘process’ proves unsatisfactory to the Health and Wellbeing Review Committee.
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