Betrayal of the East End

Anger at ministers' backtracking on plans to redevelop Bart's and the Royal London hospitals springs from a long-standing sense of grievance

Published in the Evening Standard 19 January 2006

It reads like a cry of rage. The fury sparks off the page as you read Alastair Wilson's open letter to the prime minister, published in the Evening Standard last night. Wilson is the consultant in charge of accident and emergency at the Royal London Hospital in Whitechapel, honoured for his role treating the victims of 7/7. But yesterday he wrote to Tony Blair not in the cool, calm language of a top clinician, but in the voice of a man pushed beyond his limits.

“Why oh why do Government have to kick the downtrodden?” he fumes. “What did the East End do to you that they should deserve such injustice?”

The source of his anger is the government's decision to “review” a £1.1bn plan to redevelop the twinned Bart's and Royal London Hospitals. Wilson and his team had been looking forward to working in a new, state-of-the-art medical centre, one the East End has been crying out for for decades. Just two days before Christmas they heard the plan might not go ahead after all.

No wonder they're angry. Staff feel they proved their worth a hundred times over in the aftermath of the bombings, when they helicoptered in medical teams to deal with the injured. As Wilson writes, in the era of a war on terror, and with the Olympics of 2012 looming, this is an asset London cannot afford to discard.

They fear the government's cost-cutting plan – stripping Barts's of its cardiac and cancer services – will fatally weaken the Royal London, including its medical school. And, they say, it's not as if the government didn't have fair warning of this mess. The flaws in the Private Financial Initiative – running up colossal debts to the private companies who build new hospitals - were all pointed out by critics years ago. If the government only woke up to this folly now, that's not Bart's' fault.

But this only explains part of Wilson's fury. For what makes his letter so powerful is that he is drawing on a well of East End anger that goes very, very deep.

In the second world war, it was the East End which took the brunt of the Nazi punishment, as German bombs blitzed the area night after night. We're used to seeing the archive footage of the rubble and smashed buildings; we forget that at least 40,000 people died that way (my own grandmother among them).

That, of course, remains part of the folk memory of the East End. But so do the promises made as the bombs fell. Politicians came, one after another, to tell the people emerging from the underground stations and air raid shelters that their streets and neighbourhoods would be rebuilt – that a new Jerusalem would arise on the smashed ruins of Stepney, Bethnal Green and Whitechapel.

It didn't happen. Instead people were moved out, rehoused in the new towns of Essex, in Gants Hill, Redbridge or Loughton. Most of those who moved were glad of the change – now they had an indoor bathroom and a garden - but those left behind felt betrayed. The new buildings they were promised came in the form of estates, often consisting of ugly tower blocks. This is the nerve the health secretary Patricia Hewitt is striking when she tells East Enders the new hospitals they were promised are back under review: they feel they are being betrayed all over again.

And this sentiment predates the war. “The East End has been at the wrong end of the City for a thousand years,” says Geoff Dench, co-author with Kate Gavron of The New East End, which is published next month and which revisits the landmark 1957 study of the area made by the great social entrepreneur and East End champion Michael Young. Dench argues that the City of London used the East End as a dumping ground for anything, and anyone, it didn't want – and that pattern has endured into the 21st century.

It began when the foul-smelling leather and tanning trades were shifted east in the 13th century, followed by clothes, furniture and, 400 years later, the docks. As London industrialised, all the noxious bone-boiling plants, all the heavy industry, was dumped there. “Control over trading was in the City,” says Dench. “The actual dirty work was in the East End.” Even now, the East End is criss-crossed by pylons, while waste disposal facilities line the Thames. London is like Glasgow or Paris, a place where the prevailing wind blows the foul smells eastward – sending those with money to live on the hills or out west, while the poor live in the east. Tellingly, the views of St Paul's Cathedral which are fiercely protected by London's heritage custodians are from the west, from Primrose Hill or Richmond; views from the east, from Harold Hill, Romford or Greenwich, don't count.

Eastenders retain the feeling that they are the backyard, into which is thrown whatever the rest of London does not want – and that includes people. Wave after wave of immigrants have been herded into the crowded streets of the East End – some of my own family made their start in the Rothschild Buildings on Flower and Dean Street – since that was the one place that would have them. Huguenots, Jews, Indians and Bengalis, they have all started in the East End.

The result is intense social need. Whatever measure you use, the East End is one of the most deprived areas in Britain, if not Europe. Medical students at the Royal London marvel at the range of diseases they confront, from diabetes to tuberculosis – the ailments of poverty.

This is why Wilson told Blair “The wound lies open” and that it will be no “remedy to sever the poorest limb of London.” If any area deserves all the money it takes, and for at least one solemn promise to be kept, it is the East End.

Posted on January 19, 2006 03:18 PM

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