Miriam Lantsbury, Headway East

Miriam Lantsbury has such an open and direct manner that you might imagine she has always known what she was going to do in life. Yet she had no plan, even if she is blessed with a clear personal sense of what is important to her and the moral courage to implement her ideas, whether they conform to accepted wisdom or not.

Without access to higher education, but possessing a sharp intelligence and talent for working with people, Miriam steered a path through the maze of the health service to become a quiet iconoclast, creating Headway East – a creative environment unlike any conventional clinic where survivors of brain injuries can engage in community life and rediscover their self-esteem.

Around twenty to thirty people participate in the activities each day at the centre beside the Regent’s Canal, the only one of its kind in the East End. It is a sympathetic place which permits the opportunity for members of this particular community to find their new selves in the aftermath of the life-changing experiences they have suffered, and to re-balance.

When you arrive at the day centre, you encounter people involved in all kinds of tasks and it is unclear at first who is who, or who is in charge. Yet a relaxed purposeful atmosphere prevails. And this is exactly how Miriam wants it – how she set it up and how Headway East is distinct from other such endeavours across the country. Drawing upon her experiences as a nurse in a hospital where the very structure of its organisation prevented her from treating those in need of support with the care and respect she believed they deserved, Miriam set out to reconfigure the relationships and the nature of the care, and create something more humane.

“I was born in Hackney and grew up in Wanstead. I come from a family where going to university was never considered as an option and, when I left school at seventeen, I didn’t know what I wanted to do. Our careers education was non-existent, but I met someone who was training to be a physiotherapist and I was fascinated by what she was doing. So I thought the best thing would be to get a job at a hospital and I wrote to the Royal London Hospital in Whitechapel. They asked me to an interview and said, ‘We’ll offer you a job as an auxiliary nurse,’ and within six months the ward sister and the nursing officer told me that I ought to train and become a nurse. It was never a decision. I found it interesting but I didn’t want to stay in the health service. The frustrations of the nursing profession were that you just had to do what you were told, which was no problem as far as I was concerned, but you might be in the middle of bathing an old person who was naked under a bed sheet and when they’d say, ‘Go for your coffee break now,’ you’d be expected to go – and that drove me mad.

I qualified and trained and became a Mildmay nurse, I’m a christian and it was still a christian mission then. I did my first six months there and the rest of my training at the Royal London, Mile End, St Clements and Great Ormond St. But then I got married at twenty-two and had three children and in between I did some community nursing in the evenings. I would go all over Tower Hamlets including Spitalfields. In those days, they would let you go out on your own. I was accosted on a few occasions. Then I did all kinds of jobs while my kids were growing up, book-keeping (because I’ve a bit of a head for figures), working in a playgroup, some nursing and being a receptionist at a doctor’s surgery. When my youngest went to school, I looked for something more permanent and that’s when I joined the Community Health Council as a complaints officer.

My husband saw an advert in the Guardian for someone to set up a Headway house in East London for people with brain injuries. It was just two and a half days. I went along to an interview at a day centre in Homerton and I was interviewed by five people including a psychologist and a neurologist, and it was a very hot day. They offered me the job, and I was presented with a room with nothing in it and a brief to set up a day centre. Most people with brain injuries were in hospital for two years receiving intensive support, but then they went down hill once they were released because social services knew nothing about it. So all the expensive care they had received was wasted and neurologists were seeing people decline after rehabilitation. Twenty-four-year-olds with brain injuries were sent to old people’s day centres because there was no specialist provision in East London.

No-one was there to meet me when I started work, I had to work it out for myself. I rang up the chairman and said, ‘Do you think I should come and see you?’ Then I went to visit some other Headway groups and started to learn about them for myself. I came up with a plan that included what activities we would do, how to run it day to day, how to recruit volunteers and how to get funding. We are a completely separate charity from the national umbrella group.

And now this has become a community. When I first started, I based it on what I knew and I’ve always had a lot of people around at my home, so I treated this the same way. It’s user-led because it was the most natural thing to ask people what they want to do, even if they don’t always answer. We work as co-producers here, which means that everybody participates in some way in whatever we do. What’s important is that when you arrive, it’s not obvious who is who. It’s not just about what the professionals do for the members. We have loads of activities going on which people are encouraged to join and the secret is developing activities that people want to do. There’s no point if nobody’s interested, and so you have to be continuously rethinking what you do. You can’t ever say, ‘We’ve arrived, this is how we do it.’ It doesn’t work like that.

People with brain injuries deserve our respect, but we are also interested in what they have to offer. Like the members do the cooking and I eat the food! They have experience of a life-changing event that they can pass on. It’s about treating people as I would like to be treated if I had a brain injury, not patronised but encouraged to figure out how to create a positive future. It’s fifteen years since I started this. I deliberately did not employ health service professionals because they have too many preconceptions. We have an ex-agricultural researcher, an ex-park ranger, an artist, a psychologist, and an ex-receptionist working here. All I did was employ the staff.”

Miriam on the roof of the Mildmay Hospital while training to be a nurse in spring 1979.

Miriam (right) with the very first person to come to participate at Headway East in 1997.

Miriam Lantsbury, CEO and founder of Headway East – “All I did was employ the staff.”

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