In 1946 Scott Williamson distinguished the Peckham approach arguing:
The medical approach is essentially one derived from the study of pathology. The Peckham approach—the determination of what is right with the family and its personnel and home—is derived from the other branch of biology not previously differentiated, and for which hitherto there has been neither name nor technical procedure. Let us call this branch of biology—ethology …
The systematic study of pathos of the people, or pathology, has proved its worth; but the best that can be made of a bad job with it is to stop the bad from getting worse.
In the Peckham Health Centre we have begun the study of the ethos of the people, and have made a first tentative technological approach to their ecology … any centre dealing with the pathology of a patient … can have not the slightest resemblance in practice to a health centre dealing with the ethology and ecology of the family.34
In their evocatively titled Biologists in search of material, Scott Williamson and Pearse argued that medicine, as much as biological disciplines such as physiology and pathology, was incapable of revealing anything about the healthy organism. These disciplines were dependent upon an experimental methodology which, “conditioning the environment to secure a specific effect”, inevitably led to the “emasculation of the organism”. In any case, biology should not be the study of “the organism on the defensive … running away from living so as to ensure survival” (as medicine studied disease) but rather the study of the “organism actively embracing the environment, i.e. in health”.33
Believing that modern urban living was not conducive to the promotion of health, and that the medical profession was “content with palliation as its highest goal”, Scott Williamson and Pearse sought to pioneer a new approach to health based on the concept that the “power of the environment may yet be potent to save the individual” from the threat of urban living.32 Their approach differed from mainstream medicine in that it sought to investigate “health” as opposed to “disease”, with health conceived as a relational process emerging from the synthesis of organism and environment, and not simply a desirable yet fixed “state”.
In fact it was at the Pioneer Health Centre, Peckham, that Chance first encountered the idea that social relations were central to physiological well being. He worked as director of the laboratory at the Pioneer Health Centre between leaving Glaxo in May and joining Birmingham in September 1946.30 It was at Peckham that he learnt of ethology as a methodological approach to the study of the complexity of socio-physiological relations, an experience that fundamentally altered his thought and shaped the entirety of his future career.
In the decades since its closure, the legacy of the Pioneer Health Centre has become clouded and contentious. The holistic care it offered to working-class families sits uneasily next to access fees, private donations, and constant scientific observation. Its internal workings starkly opposed the universalism of the NHS. However, since the 1990s, the NHS’s innate socialism has been undermined by gradual privatization instigated by the Conservative government, and continued in the Private Finance Initiative of New Labour throughout the following decade. In the current UK climate, the Pioneer Centre has come to represent the complexities of systems that are simultaneously private and public, accessible and protected. Now, as the NHS celebrates its 70th year, its financial ideology is no longer far removed from that of the health center it once opposed.
In recent years we have seen a surge of innovation in the commercial sector for products that allow users to self-manage their health and wellbeing without outside human intervention. Internationally we are seeing governments trialling new E-health initiatives in a desperate bid to solve growing structural and fiscal challenges within public health provision. [...] I am deeply troubled by the contraction of companies such as Babylon Health Care, who are currently piloting the ‘GP in Hand’ digital app for the NHS. The app promises ‘efficiency’ to take pressure off an over-stretched NHS. Yet it features ‘queue-jumps’ and faster testing pay bands, piggy backing us into a ACA style system. Although there is a substantial commentary surrounding the gamification and quantifying of our health, labour and wellbeing, there has been sparse empirical analysis.
Political populism, identity politics and fundamentalism have distracted us from the privatisation of public life. Silently the definition of public interest and welfare have been rewritten, leaving us with an increasingly private and economically driven health sector, redefining health as a consumer asset rather than as an innate human right.