‘NHS 88’
by Iain Stewart.

As I write, on a Thursday evening, I’m watching the clock, mindful to stop at 8pm and go to the front door with my family and most of my street to Clap For Our Carers, marking our gratitude and respect for our National Health Service, keeping us all alive and well in this time of pandemic. The weekly clapping ritual started spontaneously in other parts of Europe but quickly caught on here as an organised thank you and a morale boost – working both ways. The concept widened from applause for doctors, nurses and health workers to showing respect all those key workers who put their own lives at risk – teachers, shop staff, postal and delivery workers, public transport drivers and … the list goes on. A wave of awareness and gratitude has spread for those in tough jobs whose contributions we simply take for granted every day – or maybe we did, in more normal times.

So it is in this context that I’m delighted to be asked to share a series of NHS related photos made back in the late 1980s. These pictures are part of a larger body of work I undertook as a third year student at Edinburgh College of Art, back in 1988. The work examined the roles of auxiliary workers in the NHS in Scotland, particularly the laundry and kitchen staff at the Western General Hospital in Edinburgh. This is now, as it was then, particularly grueling and low paid work but is essential to keep the bigger machine of our NHS in motion.

The Western General series followed on from my second year project, PICTURE OF HEALTH which had examined the workings of the NHS in my hometown, Barnsley, focusing in on the relationships my parents (both General Practitioners) had with their patients. The pictures had been well received; my tutor, Murray Johnston, had even helped me frame the work and then arranged an exhibition in the college. So where I went next with my photography felt like quite an important step.

Initially I had quite big ideas about the big project for my third year, about class division, looking at the extremes of low paid work versus Edinburgh’s New Town banking elite. The late 80s was a time of choosing sides; by this point we’d had almost a decade of the Thatcher government; the Miners Strike; the anti-Apartheid Movement. Boycott Barclays! Don’t Pay The Poll Tax! Organise, Occupy, Kick The Tories Out! Students were heavily politicised. We would occupy the Art College on a fairly regular basis; pulling all-nighters to make leaflets and banners for street protests and marches. Some of this activism was bound to percolate through into our artwork.

Add in a new visiting lecturer to the Photography Department, a feisty, young photojournalist called Murdo MacLeod. Murdo wasn’t much older than us students; he had not long graduated from Napier and had energy, ideals, he didn’t dodge arguments or confrontations. I reckon he’d probably given his tutors quite a time of it at Napier. He brought quite a change of pace at ECA and I loved it. There would be loud debates and excitement on the days Murdo was in. Around this time I was discovering work by photojournalists like Don McCullin; pouring over books in the college library; the social reform photography of Lewis Hine; Humphrey Spender’s Mass Observation work; The Farm Security Administration (Dorothea Lange, Walker Evans) and Picture Post (Bert Hardy, Grace Robertson). Taking apart Bill Brandt’s pictures of the miners, being suspicious of new British colour photography from Paul Graham and Martin Parr. Like politics, at this time you chose a side; black and white or colour. I was twenty years old; life was in many senses black and white, right or wrong. Black and white for the purists!

The first step had been to write letters and make phone calls, trying to follow up contacts or make new ones. One of the early positive responses that I got was from the STUC in Edinburgh, replying to my request to photograph auxiliary staff in Lothian hospitals. Could I come in and talk to one the Union leaders? Armed with my NHS portfolio and research notes, I went in to meet him, and thankfully something about my intentions or faltering account I gave of myself must have rung true; for whatever reason I was given the green light. I could go and observe and photograph in the laundry and the kitchens at the Western General Hospital, as long as I kept out of the way.

These photos are the result. I made repeat visits, one morning a week. Initially I struggled over this series, and at the time couldn’t really understand why. Time constraints had forced me to drop the other half of my project (the banker pictures) so I gave the Western General my full attention, and it needed it. The working environment was overwhelming – huge, noisy, hot and relentless. I sensed I wasn’t always a welcome presence – the folk in there had a rhythm and a pace that really didn’t warrant stopping for a camera. Not that I wanted posed shots, but as I scanned my initial contact sheets I felt a disconnect. My earlier doctor/patient pictures had, by comparison, come easily. There was an existing relationship to latch onto, and if you tackled it correctly, discreetly, sensitively, it was a rich, rewarding subject to photograph. Here I was starting from scratch, trying to make sense of the hard graft, the noise, the mountains of laundry or the speed and bustle in the kitchens, and the pictures I was making felt a bit lost. Forming relationships with any of my subjects was a struggle too. Fair enough, really, folk were just far too busy to slow down or chat with a skinny student, however earnest.

When the pictures eventually did come good they felt quite hard won. At first they didn’t speak about relationships between the people there but instead caught them isolated in mountains of work – literally at times – or completely absorbed in monotonous, repetitive tasks and heavy or hazardous equipment. The second part to the project, and the point at which I finally knew it was beginning to go somewhere, took me away from the factory floor – observing and magnifying quiet moments during down time. Tea breaks, catching breath in the locker room, brief respite away from the noise. Slowly some of the staff opened up and gave me a minute to make a portrait.

I should add that, in my newfound enthusiasm for the medium, I had decided to try out working on 120 format for the first time, so for the second half of the project I was clunking in on the bus with a huge carry case containing a Mamiya c330, assorted lenses, light meters and accoutrements, a heavyweight tripod, and often my own small 35mm kit too. A huge learning curve – a new format, and a brief window of opportunity from a sitter who had kindly stopped work or given up a precious minute of their tea-break, so I learned to work under (self-imposed) pressure. No quarter given for fumbling with rolls of film, delay and they just moved on with work. Some of my favourite medium format shots are not portraits per se but working shots – the exhausted canteen staff, the laundry worker with far away thoughts, and this pre-35mm, almost counter-intuitive photojournalist style reoccurred later in my work. TENDER, the NHS piece I was commissioned to do for National Galleries of Scotland ten years later mined this approach too, returning to the doctor/patient relationship.

The Western General pictures were not easy pictures to make, I set myself a lot of challenges but in the process learned a huge amount about myself, about photography and photographic working practices. Looking back now, as I’ve been asked to do, I find a direct connection with our current situation; Clapping for Carers, noticing and acknowledging that there’s a swathe of hidden work going on, marking it publicly. Our collective conscience needed jolted to see that all this is being done for the common good and often with little reward. We should be mindful, and voice our thanks to our NHS and those who keep it going.

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