In the mid-1970s, the UK’s public health system experienced major budget cuts, initially introduced by the Labour government of James Callaghan (1974-1979) and subsequently reinforced by Margaret Thatcher (1979-90). These cuts led to the closure of several small hospitals across the country and resulted in considerably impaired health services. The Bethnal Green Hospital Campaign (1977-78) and East London Health Project (1978-1980) sought to oppose these problems using a process of collaboration and engagement with the local community and councils in East London. The conversation helps understand the artists’ general practices, the processes of collaboration and engagement at the centre of their work, and highlights their current relevance, at a time when the threat to the public health sector looms larger today than ever before in the UK as in many other countries.
Juliette Desorgues: In the late 1970s you started working on a campaign to fight the closure of hospitals in London. The Bethnal Green Hospital became the focus of this campaign. What led you to this?
Loraine Leeson : Peter and I were working in Bethnal Green on a Greater London Arts fellowship to run a series of video workshops for the community. This came out of a situation where we were looking for ways that we could use our work to make a difference in social terms. Whilst we were doing the workshops, we were approached by a member of the Trades Council, Dan Jones, who was part of a campaign to help keep the local hospital open, the Bethnal Green Hospital. This was the first wave of cuts in the public health service, in fact carried out by a Labour government. They were closing small hospitals, which meant that people would all have to attend the larger teaching institutions such as The London Hospital. The Trades Council were involved in the campaign and saw that we were working in the area. They asked if we could run one of our workshops in the hospital to produce a campaign video.
Peter Dunn : We started to work with the campaign steering committee and the staff from the hospital. As well as running a video workshop, we saw there was a need for posters and met that need. We created exhibitions from all the documentary material. It had originally been exhibited in the hospital foyer and later taken to other hospitals that went into occupation, because Middlesex and Elizabeth Garrett Anderson hospitals, both went into occupation at the same time. What happened at the Bethnal Green Hospital is that the staff took over. The management was pushed out and the patients were referred to the hospital through the ambulance service – who supported the campaign – so the hospital couldn’t be closed. The staff occupied it and ran it effectively. As this happened in other local hospitals, we took exhibitions to them – they contained things like tips on how to identify a potential hospital closure, such as the running down of maintenance and auxiliary services, how to sustain the occupation and keep the overall campaign active and public. As the video workshop progressed, we realised that there was a problem with quality and the speed of production necessary for an effective public campaign, so we switched tack from participation in the making to collaboration in decision-making.
L.L. We discovered in the end that it was going to be much better to work collaboratively with the campaign committee, rather than in a participatory way.
J.D. How do you see the difference between the two? Between the collaborative and the participatory?
L.L. The process of collaboration was essential to this project. Whilst retaining our role as artists, it was important not to assume that we knew everything and if we wanted to help bring about social change, it would be much better to work with people who really knew the issues. If there is a problem out there in society, it is likely that some people will already be attempting to address it, and probably with much more relevant expertise than you have as an artist.
As for participation, this is often described as if it were a passive role. But for me, all participants are also collaborators. When working with people, even today, I frame a process through which their voice can be heard. That started in this work from the 70s and 80s. We were attempting to bring the voice of campaigners into the public domain in the most powerful way we could. All our work since then has been trying to develop that sense of collaboration.
P.D. Loraine talked about creating the framework through which things can emerge in this process of collaboration. The development of that framework is crucial for a number of reasons. The first is that when people talk about an issue that deeply concerns them, they talk with passion. That passion quite often delivers powerful metaphors, which become the fuel for creating images. That is something we draw upon a lot. More importantly, the framework also allows for the deeper development of an idea through a process of exploration. That is what you do in a workshop. You take people through an in-depth process. The depth of the feelings that people have experienced are explored in their complexity. That process evolved significantly in my later work.
L.L. Knowing how to listen is key to this process of collaboration. It is essential to be able to hear and understand underneath what is said. We can’t as artists help to express something unless we hear what it is, and people have different ways of communicating that. We learned a lot from the activists we worked with about listening and negotiating. I also took some very useful training in conflict resolution, from which I came to understand the importance of different opinions. If you’re able to create a safe space in which the differences can come together in a non-conflictual way, this can lead to something new. These ‘safe spaces’ is something that can be created through an art process or even the production of an artwork.
P.D. It’s a kind of dialectical process. Developing a collaborative process that encompassed a range of people such as the campaign steering committee and the staff from the hospital, was key to the production of the work. This collaborative process, the exhibitions we did to inform people and then, finally, how we began to use of image and text in the work itself, were three key elements that we then took on to subsequent projects that we worked on.
J.D. Perhaps this is a good moment to discuss your subsequent work, the East London Health Project, a series of posters where this play between image and text was central?
P.D. Yes with the East London Health Project we started actually using less text and more image. We discovered that you could say far more by using image and text in a complimentary fashion, by juxtaposition and evocation. When we began working on the Bethnal Green Hospital Campaign, our approach was very text heavy, in a documentary style. By the time we moved into the East London Health Project, this had changed. When we engaged with the campaign in the London Docklands, we were creating images that only had a caption and perhaps one or two other lines of text when necessary.
J.D. Could you explain how this particular body of work emerged?
L.L. There was some money left over from the Bethnal Green Hospital Campaign, which the committee wanted to be used to inform people more widely about the cuts in health services and how these were affecting the local population. Rather than producing pamphlets, which might otherwise have been the case, the committee asked us to work with them to do this, which is how the East London Health Project came about.
A steering group was created for the East London Health Project and included members of the health workers’ unions NALGO and NUPE, the local Trades Council, and Tower Hamlets health campaign as well as ourselves. The health professionals knew about the issues and we knew how to represent them. We would brainstorm together with everyone pooling their expertise, and we were able to come up with something much more effective than either could have achieved on their own.
One thing that was considered was the form of the work, whether it should be video, tape slide or posters. We decided that a form which required a group to gather was not appropriate, but nor was fly posting suitable, since too much information needed to be communicated. In the end we thought of ‘visual pamphlets’, which were in effect posters suitable for display where people gather, such as in hospital waiting rooms or doctors’ surgeries.
P.D. Yes, the East London Health Project really consolidated the idea of working with a group much more intimately. We were being seen as playing an important role in the campaign process. There was much more of a dialogue as equals. We could really invest ourselves into the posters being made, experimenting with reading distances for example, using larger captions – often seeming to confound the image – to draw people in. Smaller text was then used to elaborate the issues in a lot more depth. This would filter into our practice in terms of designing for a context – these ‘visual pamphlets’ were to be used in places like doctors waiting rooms, where people would have time, and maybe be bored, so the job was to both entertain and educate.
J.D. These two bodies of work highlight the possibility for art to play an essential role, having an impact on social and political issues, and bringing on real change.
L.L. At the beginning I don’t think anybody involved in the Bethnal Green Hospital Campaign thought that we could contribute much as artists. However, it seemed that we proved our worth, which was acknowledged through being invited to create the subsequent bodies of work, including the posters for the East London Health Project.
P.D. I believe that cultural practices have a crucial role in social change.
They can expose and reveal contradictions. We can see what happens when there is a lack of it – consider the rise of Trump and the Brexit campaign (the latter built on falsehoods and illegal practices). Mythologies can be used to hide key facts and gloss over contradictions. I see that one of our roles as cultural producers is to provoke reflection and inspire alternative ways of seeing to those peddled by the «snake-oil salesmen» who dominate much of our public discourse.
One of the things that we have always tried to do is to explore how artistic practice impacts on different spheres of discourse. We start, for example, with working with the group who are the immediate participants. They’re the first and most intimate level of discourse. It’s about changing perception and that also includes our own, because we are all in a learning curve together in these processes. The next sphere outside of that, the second level, is people who may see the work but have not been involved in its development, in the case of the posters, those who see them in doctors’ surgeries. This second stage creates a resonance, we hope, through the interplay of image and text. Then there is a third level of people who may see the documentation of the work in magazines. That’s another level in which the debate takes place, in another context, for example that of art.
L.L. I also want to pick up on the importance of aesthetics, because sometimes assumptions are made that aesthetics don’t matter in this sort of work, and that it is all about the issues. While the outcome to a project is a mixture of process and product, the aesthetic resonance of what takes place, together with any outputs that emerge, is of major importance.
An analogy I often use as to how art functions in society is to regard the artist as a lens. The light that passes through this lens can come from many different sources and ideas. It then becomes refracted into an image, the artwork. This functions much like a dream, holding all the compressed meanings that have gone into it, and if the resonance of that outcome is sufficiently compelling, a viewer will interact with it, bringing to it and shifting their own perceptions. In a situation where the light comes from individuals and groups whose views are not often heard in the public domain, new perceptions can be created in relation to social and political issues and that is how art can change society.
J.D. I was interested in hearing about your influences from the time. Which artists were you looking back to and were there other artists active during that time that you felt you had affinities with?
P.D. We both had influences that had come from art history. We both started off with a fine art background. When we were dealing with photography, Alexander Rodchenko, in particular, was one influence as well as John Heartfield. The way he combined image and text had a great influence on our work. Caroline Tisdall was our tutor at university. She, of course, was a key figure at the time and was close to Joseph Beuys. She got us involved in the Free University. In terms of our contemporaries, I would say that we were also very much influenced by people from a slightly older generation such as Conrad Atkinson and Margaret Harrison. Stuart Brisley also made a mark on us. He was working through performance and was engaging with social issues.
There was a belief that as an artist you should be working with the social fabric around you. You have a responsibility to do so. That was very much the feeling at the time.
L.L. Having studied the Italian Renaissance, it seemed to me that artists, even then, were working collaboratively on social issues, even if for Church and State. They were working as teams to bring pertinent information into the public sphere, whereas the concept of the individual artist who creates saleable commodities, actually developed with the rise of capitalism. Historical perspective was able to bring wider understanding to our practice.
It’s also important to mention the rise of the civil rights movements particularly the feminist movement and Black Arts Movement. All the work we did is entrenched in this history. It is not just about equality but also recognition of different voices and values, not only in the work itself, but also in terms of how the practice was organised.
P.D. This brings me on to just say something about the influences of theory on our work. This was a time when a lot of French structuralist, psychoanalytic and semiotic texts were being translated into English. People like Roland Barthes, Louis Althusser, Michel Foucault were major influences. We of course had copies of the May ’68 posters. In the UK, the politics of representation were being debated by theorists such as Laura Mulvey, Griselda Pollock, Victor Burgin and others. We also took to writing about our practice at the time as a way of engaging with contemporary discourse. Our work was very much rooted in both history and theory.
L.L. Another reason why we wrote about this work was in order to clearly declare that what we were doing was art, even though it differed in many ways to how most artists were practicing at the time. We believed that very strongly, and still do. There were often attempts to marginalise it, and these views needed to be countered.
P.D. We referred to it as ‘transitional practice’ in fact.
J.D. When you see the political and social climate today, do you see any parallels at all from that time, particularly in the way artists are working now compared to how you were then?
P.D. Yes. There are many parallels, but also some fundamental differences. People feel powerless and disenfranchised in a similar way that they were feeling in the late 70s. The similarities in both periods I think are strong in the way that people are beginning to get active again in all kinds of different ways. What we do have now and which we didn’t have then, is digital technology. Whilst I may be pessimistic politically, I’m very optimistic in terms of what younger generations of artists are doing with new technologies to organise and activate debate.
L.L. Yes, I think it’s very encouraging to see how activism is developing in the younger generation. I have been to meetings where there have been people of my generation and others in their twenties and thirties, though not necessarily many in between. After the 80s and until recently, politics became much more individualised, which I think came from people feeling that they couldn’t really change anything. The establishment seemed too powerful. As Peter described, people today are feeling that they have to do something, perhaps being so disenfranchised that it doesn’t matter anymore. I think that’s how we felt at the time, and I feel very privileged to still be active at this moment when it’s possible to pass on to a younger generation some of the knowledge gained from my work as an artist and activist during that period.
Cover: Peter Dunn and Loraine Leeson, Bethnal Green Hospital Campaign Poster, 1977-78