BRITISH MEDICAL JOURNAL VOLUME 293 20-27 DECEMBER 1986

Medicine and Pictures

Beauty and the dole

RICHARD SMITH

Many of Britain's hospitals are ugly and depressing, and more than
three million people are unemployed. Wouldn't it make sense if
some of the unemployed helped beautify our hospitals?

It would, and a walk down the several hundred yards of corridor
of Bethnal Green Hospital shows that it is already happening. The
corridor is lined with paintings by unemployed people. The first one
you see shows a boy fishing in one ofthe East End's hidden canals. It
must be five feet by four, and a casual observer could be excused for
thinking it a particularly vibrant and large colour photograph. In
fact it is a painting, which might be described as ultrarealist, painted
by an unemployed girl who had never painted before.

If you were one of the old people who are now the inhabitants of
the hospital, you might be reminded of when you were a child and
fished in the canal. Or perhaps you would think of your grandson,
fishing there at that moment. As you walked on down the corridor
you would be reminded ofmuch more, particularly if you knew the
East End well. Tubby Isaacs is selling shellfish; bells are being cast

in the Whitechapel foundry; people are snoozing on deckchairs in
the park; small boys are collecting money for Guy Fawkes night,
while others are painting themselves as clowns; an Asian man and
his son are looking out of their shop window, just a little frightened;
the cat meat man is coming; and that cheerful woman (what's her
name again?) is still selling cigarettes from her tiny kiosk.

Similar pictures can be seen in the outpatients department at the
London Hospital. The biggest one shows the market across the road
from the hospital in full swing, and patients waiting to see the doctor
can study the characters and often recognise friends. One of the
greengrocers recently died, and in his obituary the Hackney Gazette
said that he had been "immortalised" in the painting at the London
Hospital.
The 30 or so pictures at Bethnal Green are large, and they

might-until you look closely-all have been painted by the same
person. But they weren't, although most were painted by a similar
technique, one borrowed from Venetian painters like Canaletto.

1632

 o
n
 5

 A
p
ril 2

0
2

1
 b

y g
u
e

st. P
ro

te
cte

d
 b

y co
p

yrig
h

t.
h
ttp

://w
w

w
.b

m
j.co

m
/

B
r M

e
d

 J (C
lin

 R
e

s E
d

): first p
u

b
lish

e
d

 a
s 1

0
.1

1
3

6
/b

m
j.2

9
3

.6
5

6
2

.1
6
3
2
 o

n
 2

0
 D

e
ce

m
b
e
r 1

9
8
6
. D

o
w

n
lo

a
d
e
d
 fro

m
 

http://www.bmj.com/


BRITISH MEDICAL JOURNAL VOLUME 293 20-27 DECEMBER 1986

The Venetians used lenses and mirrors to project canal scenes on to
their canvases, whereas the unemployed of the East End have used
slides and projectors. In a painstaking process that takes up to six
months they have painted the projections and created startlingly
evocative scenes. The result is that what might have been a
depressing and seedy corridor distinguished only by the smell of
boiled fish is as well worth a visit as the Hayward Gallery.
Most of these paintings are now several years old, and the

programme that gave long term unemployed people the confidence
to paint so well has moved on. Now 120 people are working on
projects as varied as creating gardens for the disabled, making
stained glass windows for the hospitals and residential homes of
TowerHamlets and Hackney, producinghealth promotionmaterial,
and building strong wooden chairs for disabled people. In addition,
the participants in the project are making sure that the patients in
Bethnal Green Hospital can share in their work, and most recently
some of the participants have begun to work directly with the old
people, helping them to make their own pictures.
The project was begun in 1978 and sponsored by SHAPE, an

organisation that encourages art in hospitals, prisons, everywhere.
Four unemployed painters spent six months in the London Hospital
and six months in Hackney Hospital. One of those unemployed
painters was Michele Bacciottini, who is now manager of the whole
project. After the first year Michele approached the London
Hospital to "sponsor" the project and the Manpower Services
Commission to put up the money. The London Hospital's "sponsor-
ship" cost it nothing: it simply had to find a corner for the four
painters and be willing for them to work on hospital projects.
They began by painting a mural ofWinnie the Pooh in one ofthe

children's units at the London Hospital. They were criticised by

some of the staff for choosing such a middle class subject in such a
working class area, but the staff were lagging behind their charges.
Although the parents of the East End might not have encountered
Pooh and his pals, their children had, and they delighted in the
pictures ofEeyore, Baby Roo, Kanga, and Piglet against a Cotswold
background.

This picture proved to be important in getting future funding for
the project because the Danish minister of health came to visit the
unit together with some "bigwigs" from the Manpower Services
Commission. He turned out to be a fan of Pooh as well as of the
mural, and the "bigwigs" enjoyed the reflected glory. This has been
useful becauseeachyearMichelemustapply again to thecommission
for money, and it is becoming increasingly oriented towards
industrial projects. The commission has always stumped up so far,
but one year a panic ran through the commission because of
criticism of some of the painting projects that it supported. A
decision was taken to stop supporting all painting projects, which
could have meant the end of the East End project.
But the people ofBethnal Green were determined that this should

not happen. A petition was organised, and local union leaders led
the protest. One wrote to Sir Hugh Casson, then president of the
Royal Academy, and asked him to come and give his blessing. He
was abroad, but the secretary of the academy came and was much
impressed by what he saw. Pressure from the academy helped keep
the project going.
The local union leaders were most helpful on that occasion, but

the unions have been suspicious of MSC schemes. Isn't this slave
labour? Aren't these second class jobs? Aren't the participants doing
work that should rightly be done by full time workers, union men?
Michele understands their point of view but is confident that this

1633

 o
n
 5

 A
p
ril 2

0
2

1
 b

y g
u
e

st. P
ro

te
cte

d
 b

y co
p

yrig
h

t.
h
ttp

://w
w

w
.b

m
j.co

m
/

B
r M

e
d

 J (C
lin

 R
e

s E
d

): first p
u

b
lish

e
d

 a
s 1

0
.1

1
3

6
/b

m
j.2

9
3

.6
5

6
2

.1
6
3
2
 o

n
 2

0
 D

e
ce

m
b
e
r 1

9
8
6
. D

o
w

n
lo

a
d
e
d
 fro

m
 

http://www.bmj.com/


BRmSH MEDICAL JOURNAL VOLUME 293 20-27 DECEMBER 1986

...

isn't the case. The participants in his project are artists, and there
were no artists in the hospitals of the East End before they came.
Nobody made gardens or painted pictures to brighten the walls. He
is also sure that the work that the participants do with the patients is
something new and different. Something extra is being achieved,
nobody is being pushed out.
But the real beauty of this project is that it is not just the patients

and the hospitals that benefit-the participants benefit as well. All
of them are long term unemployed people, and many have spent
years unemployed in the East End-"a real tough experience,"
observes Michele. Many have had their confidence destroyed, and
some have had serious problems-have attempted suicide, been for
psychiatric treatment, or been in prison. They come to the project
for a year, and Michele sees dramatic changes in their attitudes and
confidence. These come partly through mastering skills, partly
through working in teams, and partly through working with the
patients. What can be hard, however, is leaving after the year is up.
But 60% do go on to get jobs-many ofthem as care assistants or in

art related jobs-which is a better rate than for many MSC projects.
Whether the participants or the patients benefit most is anybody's

guess, but I had a chance to see what pleasure was given to some of
the patients. One of the participants in the project had been given
space to exhibit his own work at the Half Moon Theatre in Mile
End. He had given over his space to the patients, and I went to see
the exhibition. The old people that I spoke to were terribly chuffed
that their work was being exhibited. Most had never painted in their
lives before and didn't think that they had it in them to create
anything that people would want to hang on a wall. As the daughter
of one woman said: "I didn't fink she could do nuffin with them
'ands, and yet the painting's wonderful and it's on the wall. It's
made 'er really 'appy."
The greatest success of the whole project seems to have been to

help people to do things that they never thought they could do.

Dr Richard Smith is assistant editor, BMJ.

1634

 o
n
 5

 A
p
ril 2

0
2

1
 b

y g
u
e

st. P
ro

te
cte

d
 b

y co
p

yrig
h

t.
h
ttp

://w
w

w
.b

m
j.co

m
/

B
r M

e
d

 J (C
lin

 R
e

s E
d

): first p
u

b
lish

e
d

 a
s 1

0
.1

1
3

6
/b

m
j.2

9
3

.6
5

6
2

.1
6
3
2
 o

n
 2

0
 D

e
ce

m
b
e
r 1

9
8
6
. D

o
w

n
lo

a
d
e
d
 fro

m
 

http://www.bmj.com/


BRITISH MEDICAL JOURNAL VOLUME 293

I

I P. ..

Hi_ Tic--

20-27 DECEMBER 1986 1635

-&I'.'..-e

 o
n
 5

 A
p
ril 2

0
2

1
 b

y g
u
e

st. P
ro

te
cte

d
 b

y co
p

yrig
h

t.
h
ttp

://w
w

w
.b

m
j.co

m
/

B
r M

e
d

 J (C
lin

 R
e

s E
d

): first p
u

b
lish

e
d

 a
s 1

0
.1

1
3

6
/b

m
j.2

9
3

.6
5

6
2

.1
6
3
2
 o

n
 2

0
 D

e
ce

m
b
e
r 1

9
8
6
. D

o
w

n
lo

a
d
e
d
 fro

m
 

http://www.bmj.com/