Closure of St Clement’s Hospital
The closure of St Clement’s Hospital in Bow Road - with a move to a new purpose-built complex at the Mile End Hospital in Bancroft Road is one of the final (and long overdue) breaks with the asylums of Victorian times. The new centre, with its quiet areas, lounges, landscaped garden and family visiting rooms could hardly be in greater contrast to the dread hospitals of a century and a half ago. In those days, the line between mental hospital, workhouse and prison was blurred at best - and that can be seen in the genesis of St Clement’s.
The original buildings of the St Clement’s Hospital were raised in 1848-49 as a workhouse, for the Board of Guardians of the City of London Union. The workhouses, the first of which opened in the 17th century with the last not closing its doors unitl the early 1930s (the workhouse system was abolished in 1929), were the last safety net for the poor. Designed to be as unpleasant as possible (there was a fear among the powers that be that any raising of the minimum standard would see the working classes giving up on work and opting for ‘poor relief’ instead) they were loathed and feared by the ordinary people. Oliver Twist may have given a highly coloured picture of the workhouse, but maltreatment was not uncommon - and of course entering the workhouse meant the family was split up.
Extraordinary then that a workhouse should have been thought suitable for transformation into a psychiatric hospital - but then the care of those suffering mental illness was a very different thing in Victorian London. The world’s first psychiatric hospital was in the East End of course, the Bethlem Royal Hospital was established in 1330 on the site of what is now Liverpool Street Station. Restraint rather than cure was the order of the day and progress was slow. Nobody really knew what mental illness was. The afflicted were called ‘lunatics’ from a primitive belief that their maladies were caused by the cycles of the moon (from which the werewolf legends also descend of course), and there was a not so fine line between mental illness and demonic possession in the minds of many. and things hadn’t moved on much by the 1800s, though by 1700 the ‘lunatics’ were at least being called patients.
From 1725, Bethlem apparently accepted that some patients could be helped, opening a ‘curable’ ward which - more ominously - was followed by an ‘incurable’ ward. But what was wrong with these unfortunates? Morality and sanity were confusingly conjoined, with ‘moral insanity’ being a common diagnosis. Deviation from the sexual mores of the time was a common reason for committal - some of the patients at St Clement’s might have done nothing more than have a baby out of wedlock and failing to conceal the fact.
And not for nothing did Bethlem become corrupted to ‘Bedlam’. Well into the 19th century visitors could pay a penny to watch the peep show - the sane Londoners amusing themselves by observing the very perversions and aberrant behaviour for which they’d locked up the unfortunate lunatics. Antics of a sexual nature were particularly popular of course, and during 1814 there were 90,000 such visits to Bethlem. In our more civilised times we take our voyeuristic pleasures at one remove … William Hogarth (currently showcased at Tate Britain) in his celebrated panel piece ‘A Rake’s Progress’ shows his dissipated hero finally ending up in the Bethlem asylum.
When St Clement’s opened in 1848, Bethlem had been recently demolisehd and moved to Lambeth (in what is now the Imperial War Museum). The sexes were now separated (the censorious Victorians were more wary of sexual freakshows) but the regime was still brutally harsh, with many being punished for their sexual incontinence. The workhouse was converted into an infirmary for the City of London Union [workhouse] in 1874, and in 1912 was reopened as the Bow Institution for the chronic sick.
Workhouses went in the early thirties and the hospital, renamed St Clement’s in 1936 became an exclusively psychiatic unit. It survived major bomb damage in 1944, and became part of the London Hospital in 1968. The treatment of mental illness has moved on and the site of St Clement’s is to be used (probably) for social housing.