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Our history

In a place that combines enduring inequalities and solutions that have shaped the world, we’ve been a constant at the leading edge of health.

Children at play mural near Stockwell Park

South London: health inequalities and efforts to address them

Our organisation’s story is interwoven with the history of London and the health of its people – the stark inequalities that have persisted for centuries, and the trailblazing efforts of innovators and reformists to address them.

The history of our place

1500s

Our donations and legacies date back to the 16th century

14 years

The gap in healthy life expectancy in London between areas is 14 years

1860

In 1860, Florence Nightingale established the first professional training school for nurses

London, a vibrant and diverse city, is home to 8.9 million people. It is one of the most expensive cities in the world, but there are also areas with high levels of deprivation, in particular in parts of East London and our home of South London. As with other global cities, unequal health outcomes persist, and life expectancy varies widely across the city.

Lambeth and Southwark, in the heart of the capital and where our home is, are two densely populated boroughs. They cover 59 square kilometres, an area half the size of Paris or exactly the size of Manhattan. The boroughs have a joint population larger than that of Manchester, though in half of the space.

They are vibrant and have a rich social and ethnic mix. The proportion of Black residents is amongst the highest in the country, with a long established Caribbean community. Our boroughs are also home to more recent migrants from Africa, Europe and Latin America.

They are also places with stark and pervasive inequality. As powerfully demonstrated in Charles Booth’s work in the late 19th century, poverty and wealth have co-existed in South London for hundreds of years. Londoners with varying degrees of prosperity and opportunity have mixed within small neighbourhoods for many generations.

Charles Booth map of South London
Charles Booth's map of London poverty from 1898-9, showing wealth and poverty sitting side by side in South London

In the 19th century, manufacturing flourished along the riverside while the southern parts of the boroughs provided homes for the City and West End’s fast-growing workforce. Bombing during the Second World War badly damaged industry and homes in neighbourhoods from Bermondsey to Vauxhall, creating the impetus for the construction of large social housing estates. Latterly, de-industrialisation has opened up space for high-rise private residential development.

This historical backdrop of rapid growth, industrial change and migration has left the boroughs with a complex inheritance. The range of health outcomes in Lambeth and Southwark is as wide as the range of health outcomes across the whole of London. For example, in Burgess Park, one of the most deprived areas of the boroughs, female healthy life expectancy is 59 years old. In wealthier Herne Hill it is 74 years old — a 15-year difference just a few kilometres apart.

A place of pioneers and change-makers

At the same time, our home has also been at the centre of ground-breaking social reforms and innovations to reduce these health inequalities.

As far back as 1173, some of the most vulnerable people in the city could find healthcare south of the river at St Thomas’ Hospital, which was initially run by religious institutions and has been supported by benefactors and philanthropic donations throughout its history.

Florence Nightingale’s far-sighted reforms, which set new standards of modern healthcare, also have their roots in South London. In 1860, Florence established the first professional nursing school in the world at St Thomas’ Hospital. From pioneering the role of data in health, to realising that the hospital environment and diet can impact health and recovery, she left an indelible imprint.

Florence Nightingale diagram of the causes of mortality
A diagram on causes of mortality by Florence Nightingale, who pioneered standards for modern healthcare, including sophisticated use of data

A contribution to the sanitary history of the British army during the late war with Russia. Attribution: Wellcome Collection, 4.0 International (CC BY 4.0)

 

Social reform experiments in South London in the early 20th century focused on investing in a healthier society by improving the social and economic determinants of health. For example in 1922, Ada Salter became the first female mayor of Bermondsey, in Southwark. She was best known for setting up the ‘Beautification Committee’, which aimed to turn the area into a garden city by planting trees on the new estates and streets. Salter recognised that improving the environment was a key part of improving people’s lives.

Also south of the Thames, in Peckham, the Pioneer Health Centre was the home of the Peckham Experiment from 1926 to 1950. A purpose-built centre in which doctors observed families socially interacting, the experiment aimed to highlight the role that the environment plays in improving health, challenging the prevailing notion of health as ‘the absence of disease’.

These initiatives and reforms have had an impact not only on our capital but across the world. It’s a legacy we and our partners aim to build on today.

Source: Wellcome Collection. © Pioneer Health Foundation. Attribution 4.0 International (CC BY 4.0)
A family in the Pioneer Health Centre, designed to study health rather than disease

The Homestead. Source: Wellcome Collection. © Pioneer Health FoundationAttribution 4.0 International (CC BY 4.0)

Philanthropy and its impact on health

The health issues that pervaded London during the 17th and 18th centuries prompted philanthropists and benefactors to fund healthcare for those in greatest need. They also pioneered changes to the environment to help improve the health of people across the capital.

Our own endowment formed over hundreds of years. Some of our donations and legacies date back to the 16th century, when Edward VI, son of Henry VIII, re-opened and endowed St Thomas’ Hospital after the Reformation.

When the NHS was formed in 1948, hospital funding was taken on by the government, with core healthcare services provided to all citizens free at the point of care.

However, the advent of the NHS did not solve the underlying issues of unequal health outcomes, particularly in densely populated cities such as London. Today, along with continuing to enhance experiences in healthcare, independent endowments such as ours seek to have the greatest possible impact by addressing these inequalities head on.

Life at Guy's Hospital by Geoffrey Earle Wickham
Guy's Hospital was founded through philanthropy, created to treat those deemed 'incurable', depicted by Geoffrey Earle Wickham in the painting 'Life at Guy's Hospital'

Significant donations for South London’s health

One of our most significant donations came from Thomas Guy, who gifted one third of his estate in 1724 with the instruction to treat ‘the incurable’ health challenges of people living in the area.

Thomas Guy served as a governor of St Thomas’ Hospital from 1704, and donated to the rebuilding of the hospital. A large amount of Guy’s wealth came from investments in the South Sea Company, an organisation that transported enslaved people across the Atlantic. Guy contributed to our endowment and his initial investment, which appreciated over time to be worth around £200,000 during the financial bubble of 1720 (approximately £424.7 million in today’s values) helped build the world-renowned Guy’s Hospital.

Another major donor, Austrian Baron Ferdinand de Rothschild, funded the original Evelina Hospital for Sick Children, which opened in 1869. The hospital, built in memory of his wife who had died in childbirth, is today Evelina London Children’s Hospital, one of the leading providers of healthcare for children and adolescents in the capital and the South East.

 

Evelina Gertrude de Rothschild by Samuel Bellin, after James Sant. Mezzotint, published 1857. NPG D39893 © National Portrait Gallery, London. Licensed under CC3.0

Addressing the legacy of colonialism

Like many British institutions stretching back to the 16th and 17th centuries, our history is connected to England’s colonial expansion and the trade in enslaved people.

Alongside Thomas Guy (see above), another important figure in our history was Sir Robert Clayton. He contributed to our endowment, was a president of St Thomas’ Hospital and donated money to its rebuilding. Sir Robert Clayton had direct connections to the transatlantic slave trade, the plantations business, and English colonialism. He was a principal member of the slave trading corporation the Royal African Company (RAC) from 1672 to 1681.

We believe we have a duty to address this legacy of colonialism, racism and slavery and to understand its impact on health and healthcare today.

While we cannot change the sources of some of our endowment, we can continue to use the funds to have a positive impact on health, and use the lessons from our past to help build a more equitable future.