PATIENT THREATENS LEGAL ACTION AFTER 20-HOUR TROLLEY WAIT IN A ‘FLAGSHIP’ HOSPITAL CORRIDOR (Evening Standard, 10 October 2001). Kerrie Williams, ‘mother-of-two’, is quoted as saying: ‘I’m amazed I actually got through it and lived to tell the tale.’ While lying on a trolley in a corridor, she was ‘intimately examined’, but given no food or water for two days. Williams now understood perfectly what the private/public partnership meant: go ‘private’ and receive swift treatment, while Joe Public expires on an unattended gurney.
‘The place,’ Kerrie Williams reports, ‘was in chaos.’ The new hospital cost £177 million and was built under the scheme whereby the private sector (the same contractors we have met, time and again, on our circuit) throws up something fast and glitzy — and rents it to the NHS. A sweetheart deal. Plenty of glass, generous parking bays and very few beds. Consultants (unconsulted) warned that the Darent Valley Hospital would be too small and that there would be long delays in the A & E Department. In other words, inner city conditions would apply to the perimeter, to Kent. You won’t find the drug war casualties of Hackney, mercenaries hosed from the forecourts of night petrol stations. You’ll have to make do with road rage, the boredom-stompings of Thamesmead, pub brawls. Feuding inbreeds. The BNP Calibans of economic decline. Middle-class families walking across fields attacked by hammer-wielding maniacs.
The Department of Health may not be much use at delivering hospitals that work, but they are very good at charts, projections, tick-the-box quizzes. The flagship Darent Valley Hospital was judged (in September 2001) to be ‘one of the worst in the country’. Its rating by the Department’s new classification system was: zero. Zilch. The pits of the pits.
We step out of Dartford station into a non-negotiable nexus of underpasses and flyovers. The retail fly-trap with its herringbone-brick roads and freakishly thin clock tower is known as ‘The Orchard’. It is of course barren and treeless. It acts as a reservation of New Commerce, an escape from the declining Spital Street, the deceased High Street. ‘Spital’, as a signifier, belongs to the era when Watling Street was still an active concern, when positive discrimination invaders (Romans, Vikings) were marching through — bringing leprosy and the ‘sekness that men called ye pokkes’. Dartford was an important staging post on the road to Canterbury, a hill to climb. Workhouse became hospital, became asylum. Isolation was the pitch. The desolation of the marshes (liable to flooding) made Dartford a prime site for pox hospitals, tents for contagious diseases.
The Wat Tyler pub offers: PEASANTS REVOLT BITTER. £1-49 PNT. 3.8 PC. WAT TYLER AND SEVERAL OF THE COMMONS CALLED AT THIS ANCIENT TAVERN (SO IT IS SAID) TO QUENCH THEIR THIRST WITH FLAGONS OF ALE.
Negotiating a route to Joyce Green Hospital, we find ourselves on Temple Hill; commercial imperatives overrule travel information. B & Q. CLEARWATER OPEN FOR BUSINESS AS USUAL. A Mercedes dealership with a forest of flags. A walk of ‘about twenty minutes’ (pitched by the woman in the breakfast caff) stretches into an hour of uncrossable bypass, marsh mud, site-specific rain. My plate of ham and eggs has been sprayed with a silver film. I can’t decide whether to eat it or to have it framed.
Dr Burne is waiting in an office in the Postgraduate Building, sucking at a mug of tea, tapping on a tin of biscuits. The hospital estate with its winged design, its outbuildings, open-air corridors, flower beds and shrubberies, is posthumous. We’re used to that, we’ve come to expect it: good-humoured resignation, folk hanging about in warm rooms nibbling through the remaining stock of chocolate digestives. Waiting for the rumble of JCBs, the skips and Portakabins.
‘What’s your interest?’ Burne challenges. He’s seen off plenty of time-wasters, professionally bored media casuals, work experience docu-directors asked to knock up three minutes on TB or cholera. The doctor is alert, gold-spectacled, silver-bearded and forward-leaning. ‘Trams, plants or smallpox?’
‘All,’ Renchi says, playing safe.
‘And you?’ Burne prods his stick at me.
‘Poking about anywhere that wants to keep us out.’
That satisfies the archivist. He’s on his feet and heading for the door. ‘Come on. What are you waiting for? There’s plenty of ground to cover.’
Long retired from his work as consultant pathologist at Joyce Green, the doctor devotes himself to its history. He could be Renchi, twenty years down the line: wind-scoured, wrinkled, bald on top. He wears a bright red sweater, dark blue, weatherproof jacket and a Russian hat. He moves rapidly and in bursts, a silent movie: Trotsky on the trot. Renchi, in his flapping headgear (yak herdsman), struggles to keep up.
‘Swollen toe, not gout,’ says Burne, excusing the stick. The glass-roofed, open-sided walkways are suntraps: one long avenue pivoting into another, a true arcade project. With views on a miraculous garden. Here, diseased Londoners could be aired, cobwebs blown off by river breezes. Blended zephyrs: exotic plants, sewage farm and byre.
Joyce Green was a hospital, or series of hospitals, surrounded by farmland. The 1778 map in Hasted’s History of Kent shows four farms on the Dartford marshes. ‘Joyces’ stood beside a lane, leading to Long Reach, which was lost in the 1953 floods. Richard Joyce worked a gravel pit on land acquired by the hospital. His farm enjoyed fresh water from a loop of the Darent and gave good grazing, the soil was rich from regular inundations by the Thames.
Some 341 acres of farmland were purchased by the Metropolitan Asylums Board for £24,815: the Joyce Green Smallpox Hospital, opened in 1903, was the final element in the Dartford colony. Dartford, it had been decided, was the ideal distance from London for the treatment (or removal) of Lunatics and the Contaminated: madness and the pox. There were asylums and schools for imbecile children.
Cattle from Joyce Green farm returned from the marshes by a circuitous route that took them through the hospital grounds. Cows peered in at ward windows. Great, slow, curious beasts stared at convalescents in the airing courts. They grazed the hospital lawns where the grass was too tough for hand-mowers.
Dr Ricketts, a medical supervisor of fierce reputation, was granted a vivisection licence in 1904 to experiment on farm animals, to hack them about as part of his investigation into smallpox. The notion that cattle might be affected by East Enders taking their dose of pale sunlight is a nice reversal of Edward Jenner’s pioneering research. Jenner discovered that humans could be protected from smallpox by the use of fluid taken from vesicles found on the udders of infected cows.
In the Edward Jenner Museum, near Berkeley Castle in Gloucestershire, are a number of exhibits donated by Joyce Green Hospital. There is a stereoscopic viewer through which the visitor gazes, expecting some example of Victorian or Edwardian topography. Morally uplifting landscapes. Alpine scenery. A Scottish lake. A spa town. The effect is three-dimensional, nicotine-stained sepia. But the stereoscope defies expectation. Dr J.B. Byles, compiling material to illustrate a book by Dr Ricketts, photographed the action of poxes in intimate detail. Skin as a map, a meteorology of infection; flushed and angry (like those charts that divide London into zones of comparative poverty).
Dr Burne is proud of Joyce Green’s paradise gardens, contrived and planted against prevailing conditions, on the edge of a salt marsh. He rattles out the Latin names as he swerves through the estate, pointing with his stick, swooping on some previously unnoticed growth. Walnut trees. Juniper bushes thick with strange fruit, cigarette butts (flicked from the staff room window). There are memorials to surgeons and gate-keepers and a seat dedicated to the Joyce Green gardener, Harry Hopkins.