Women’s Healthcare

Elizabeth Garrett Anderson, a suffragist who was the first woman to qualify as a physician and surgeon in Britain, established the St Mary’s Dispensary, which developed into the New Hospital for Women in 1872. In 1889 it moved to a state-of-the-art, purpose-built site on Euston Road, incorporating teaching facilities and the headquarters of the Women’s Medical Institute. Renamed after its founder shortly after her death in 1917, the hospital was unique in providing poor women with the services of qualified women doctors.

By the 1970s, however, it was considered, in the words of Social Services Secretary Barbara Castle, a ‘small, uneconomic building in an expensive location’. After months of speculation about its future, Castle confirmed in a written answer to the local MP, Lena Jeger, on 12 February that the hospital would be closed. ‘The best solution is to transfer the facilities provided by the hospital and maternity home to a district general hospital within the same area in an identifiable form which preserves the original concept of the hospital,’ she said.

But patients, physicians, and other staff were deeply sceptical that the original concept would survive as part of a general hospital. In a film made by Chris Thomas as part of the anti-closure campaign, a young patient explains just how vital the EGA was. ‘I find it very difficult to explain problems to male doctors; they don’t really understand the problem that women have as much as a woman doctor herself does,’ she says. ‘I think the hospital should be increased, not decreased. The waiting list is up to three years for some operations, whereas here you come up to the hospital and you’re in the operation within three months.’

Worse still, the Camden and Islington Area Health Authority (AHA) proposed an almost immediate relocation to the Whittington Hospital several miles north. ‘If we go up to the inadequate facilities provided, temporarily, at the Whittington Hospital, with not enough beds, not enough operating sessions, we think this hospital will die,’ Ann Boutwood, consultant gynaecologist, explains in the film.

Resistance from doctors, nurses, and other staff through most of 1976 did little to alter the AHA’s resolve to complete the closure by the end of the year. So, on 15 November of that year, staff and campaigners took matters into their own hands and declared the hospital occupied. It was Britain’s first hospital ‘work-in’.

The Work-in

The action was branded as a work-in because the aim was not to disrupt the hospital’s services — but rather to maintain them. For the forty-four patients in situ at the time of the occupation, it was business as usual. ‘They will in no way be affected by the occupation,’ Confederation of Health Service Employees (COHSE) official Tom Devine told a press conference. ‘Doctors are continuing to refer cases to us, and a full service for the patients will be maintained.’

The Camden Journal, which had recently appointed a community-focused (and socialist) editor, Eric Gordon, provided regular coverage of the fight to save the EGA over the next three years. ‘EGA workers now find themselves at the spearhead of a national campaign by hospital workers to fight closures and cuts planned by the government,’ the newspaper reported. In Camden the struggle was especially acute. In the week the work-in began, AHA bosses were revealed to be plotting the closure of the obstetric unit, radiotherapy department, and cardiothoracic beds at nearby University College Hospital (UCH).

The most visible aspect of the EGA struggle was a 24-hour picket — not to prevent staff or patients from entering, but ‘to ensure equipment isn’t removed from the building and the patients aren’t just carted out’, as National Union of Public Employees (NUPE) shop steward Pam Jones explained. The picket was maintained through a shift system, with different trade unions — from both within and outside the hospital — taking on four-hour shifts alongside trades councils and women’s groups.

It was Jones who first told Linda Clarke, then a PhD student and secretary of the Camden Tenants’ Federation, about the plans to close the EGA. Clarke was appalled. She soon became secretary of the Save EGA Campaign. Forty-six years later, Clarke, now professor of European industrial relations at the University of Westminster, explains:

We’d known each other forever, so it was automatic really to get [involved]. Organising the picket was quite difficult. We had a rota — oh God, a nightmare to keep it going! [The campaign] absorbed almost a year of my life, I think.

An action committee, led by physicians at the EGA, had already been established, but the Save EGA Campaign was set up ‘with representatives from different bits, the unions, the tenants — which tended to be fairly representative, rather than just anybody’. Its slogan? ‘EGA Stays OK.’ While welcoming members of different political groups, activists wanted to keep the campaign broad and non-sectarian, and not have it taken over by marginal groups with a tendency to ‘take over, make a lot of noise and [achieve] nothing’, Clarke explains. ‘We wanted it not to be that.’

An Industrial Battle

By the time the work-in began, Castle had left the cabinet for the last time. James Callaghan, the new prime minister, appointed David Ennals as social services secretary in her place. He added fuel to the fire in early 1977, when he suggested in a letter to Stallard that the work-in could lead to the full withdrawal of women patients being treated by women doctors.

The work-in tactic had been popularised by the unions at Upper Clyde Shipbuilders in 1971, where the communist-led rank-and-file in fact increased productivity under workers’ control — and forced Edward Heath’s government to save the yards. But at the EGA, the AHA had a weapon in its arsenal to prevent the hospital operating as normal.

A broken lift — apparently shoddily built in an extension to the hospital a decade before — prohibited patient access to key areas, reduced capacity from 107 to 77 beds, and put the operating theatre out of use. ‘The bloody lift, that was an absolute nightmare — and they wouldn’t repair it,’ recalls Clarke. ‘It was just so annoying and frustrating, that whole question of the lift.’

The AHA said repairing the lift would cost between £30,000 and £100,000, a figure disputed by shop stewards. The plot thickened when campaigners asked to see the maintenance file for the lift, only to be told it had been lost. Meanwhile, the AHA was forking out £600 a week for scaffolding surrounding the lift — seemingly confirming campaigners’ suspicion that the lift was being used as leverage in the push for closure.

By April 1977, Ennals’s deputy Roland Moyle had conceded that the EGA occupation would not be ended with eviction. ‘We intend that the unique treatment offered by the EGA should carry on at the Whittington,’ he said. ‘But if the workers refuse to move, we will leave them there. We certainly shall not be throwing them off the premises.’

The transfer was postponed once again, but the unions remained vigilant: shop stewards at UCH threatened to down tools and ‘paralyse’ their hospital within twenty-four hours of a transfer to the Whittington. By September, Ennals was telling campaigners he had been ‘converted’ to the need for a dedicated women’s hospital, though he still insisted this should be part of the Whittington.

As the struggle continued, friction emerged between the doctor-led Action Committee and the community-based Save EGA Campaign, which had greater involvement from other sections of the workforce. ‘That was a bit tense sometimes,’ Clarke recalls, laughing over a draft letter — which she believes she never sent — branding the EGA ‘a middle class elite club of old-fashioned women with no interest whatsoever in the local community’.

Within the hospital and the broader NHS workforce, the cuts were raising political consciousness. ‘A lot of us didn’t belong to the unions, but we now realise that it is only by unity that we will get anywhere, and unity is strength,’ explains Mrs George, a NUPE shop steward at UCH, in the film. ‘I would say to everybody, join the unions and the one way that we in London can stop these cuts is by everybody joining, and everybody getting together — not only ancillary workers, but doctors, nurses, and everyone.’

Catering worker and COHSE shop steward Cecilia Forrest, meanwhile, gives short shrift to armchair union members. ‘Even people in the union, when they go marching or we go protesting, you got union members [who] say, no I’m not coming out; they’re afraid to lose a day’s pay, they’re afraid they [will] get the sack; and you got to lose a lot to gain a lot, and they don’t know that. If you don’t push in sometimes, you don’t go.’

The EGA saga came amid an explosion of feminist activism, and male trade unionists found themselves in the rare position of taking part in a women-led campaign. But for many, it was just common sense. ‘As a trade unionist, I believe it’s very important that we should support other trade unionists in their disputes, and at the same time we should be fighting against the cuts,’ Jim Spencer, a docker from Greenwich, explained. ‘Because in the future our wives, our children, and ourselves at some point will need these hospitals that at the moment are being closed down.’

A Landmark Victory

By May 1978, Ennals had approved what was seen as the official death sentence for the EGA, but he was soon forced to postpone closure once again, to July that year. After a fierce escalation of the campaign, with workers and patients bringing traffic on Euston Road to a standstill, Ennals scrapped the July deadline and gave the EGA a stay of execution.

The Action Committee had appealed to every quarter possible for support, and it got some unlikely endorsements. Responding to a letter to the new Conservative leader Margaret Thatcher, opposition health spokesman Gerard Vaughan described the proposed closure as ‘absolutely monstrous’.

Vaughan became health minister when the Tories were swept to power in the May 1979 general election, but the fate of the EGA formally rested with the AHA, which met shortly after the election to rubber-stamp closure once again. This time, it claimed that a shortage of permanent nurses was endangering patient safety at the hospital. Fifty women from the Save EGA Campaign staged a two-hour sit-in, which prevented the AHA from meeting at all.

The following week, Vaughan’s boss, Social Services Secretary Patrick Jenkins, confirmed that the EGA would remain open as a forty-bed gynaecological unit, with eighteen day-care beds. Campaigners were glad that the hospital’s future was assured, but they vowed to continue the fight to restore its full range of services.

The Action Committee continued to hold ministers’ feet to the fire, and many of the activists in the Save EGA Campaign would go on to be involved in other community struggles. These included the Save the Camden Journal campaign — a year-long strike mounted after the newspaper’s parent company tried to shut down the radical paper — and, somewhat ironically, the 2009–10 campaign to save the casualty and maternity units at the Whittington.

The EGA itself amalgamated with the Obstetric Hospital in 2001 and moved away from the Euston Road site. In 2001 it moved again, to a wing of the rebuilt UCH. The Euston Road building now fittingly forms part of the national headquarters of Unison, the successor union of NUPE and COHSE.

For Clarke, the struggle continues:

There was a lot going on, it was a funny period really. We were all sixty-eighters, and that’s not to be forgotten. We all thought we could change the world. We were quite convinced. Actually, I’m still convinced — but it seems to be taking rather longer than we thought at the time.