Spitalfields Life

‘You cannot overestimate sitting down quietly with someone and listening to what they have to say’

Mary Burd worked as  Clinical Psychologist at the Jubilee St Practice in Stepney between 1979 and 2009, beginning as a mental health trainee and eventually becoming Head of Mental Health Services in Tower Hamlets. Over this time, she saw great changes both in the nature of the East End and in the health service itself. In thirty years of work, Mary grew deeply engaged with the lives of those that she served and, when I interviewed her recently, she spoke to me with deep affection for the people and the place.

“When I was twenty and first came to London in the sixties, a friend of mine said to me on a spare evening, ‘Why don’t you come to the East End? I work in a youth club there.’ That visit to Dame Colet House was my very first time working in Tower Hamlets, I helped out in the youth club and I can remember it was pretty tough. I had to guard the cash box from Les whose main interest was to raid it.

Ultimately, it was chance that brought me to work in the East End. In my early thirties, I decided that I needed to change career – I had been working in publishing – so I went and did a psychology degree at Brunel University and then studied Clinical Psychology at the University of East London. It was a three year course with placements and I was based at the Royal London Hospital in Whitechapel. In my final year I could chose, and I always wanted to work in General Practice, so I went to the Jubilee St Practice in 1977 which was operating in portacabins then.

I remember sitting around the table with the group of GPs. A rather elderly gentleman asked me, ‘What are you doing here?’ I said, ‘I’ve come because I would like to provide psychological help within practices, rather for everybody to have to go to the Outpatients Department.’ And he said, ‘I think you’d be better off working in John Lewis.’

In spite of this, I had an amazing time and I did a lot of work with Health Visitors, helping them with babies and toddlers who had behavioural problems. Often, they couldn’t sleep or didn’t eat properly. I used to accompany the Health Visitors and help them think about what was going on. I got a research grant to look at the application of psychology in Primary Care, but it was really just an excuse to stay on at the Jubilee St Practice. At the end of that, the Director of Nursing said, ‘We really like the work you have done with Health Visitors and we are creating a psychology post for someone to do that sort of work.’ So that was how I started off.

I had a job that I loved working in General Practice in the East End. In those days, there was very little mental health provision and I was lucky enough to go into a practice which was forward thinking. It comprised three doctor’s practices that had come together and, when one of those GPs died, his relationship with his patients was so strong they all joined his funeral cortege.

When I first came to the East End, there were only a few practices that had more than one doctor and a few helpers. There were a lot of elderly doctors operating out of converted shops. I remember going to a practice to talk about the service and the only examination couch was in the kitchen, and it was propped up on old medical journals. There was so much dust you could write your name in it and there were files scattered about the place without any proper confidentiality. It was completely archaic and that was in the early eighties, not so very long ago. Because healthcare was so prized by people in the East End, who had never been used to decent medical services, I think they put up with things that people in other areas of London might not have done.

Jubilee St Practice became my home in the East End. I was always ambitious and I used every attempt to get funding for my work, and I taught on the East London Vocational Training Scheme, training GPs. I found that GPs who came onto the East London Scheme tended to stay in Tower Hamlets, so I got to know them all. It meant that, when they came to practice, they were receptive to the things I was doing and it gave me easy access into the world of General Practice.

As the doctors practicing in High St shops retired, the Family Practitioner Council invested in new practices. The new GPs coming in were of a high calibre and they wanted to practice in decent surroundings to give the best possible care. They were keen on the idea of a multi-disciplinary team, so they worked with nurses and Heath Visitors. By the time, I left every practice in Tower Hamlets had onsite psychological support.

In the early days, I set up a referral service. So a GP could come to me and say, ‘I’ve Mrs X and she’s terribly depressed at the moment, do you think you could see her?’ I would not work with a practice unless they would give a minimum of an hour a month to discuss the patients. There was a tremendous sense of partnership. We worked so closely and it was a fantastic time.

I was very often asked to write housing letters but in all my time I only wrote two, because I knew there was absolutely no point. Instead, I can remember writing the the local authority saying, ‘What is the point of me providing a service to a young woman with four children living on the fourteenth floor of a tower block?’ By then, many families were moving out but there were still many extended families. I remember asking a young mother, ‘How often do you see your ma?’ and she said, ‘Oh not very often, only three times a week.’ I think living cheek by jowl brought pressures. The positive was stronger than the negative but, even so, some people were oppressed, not the young children but the mothers. Their own mothers used to go round and do the washing for them, and there was a real dependency.

I was in Jubilee St during the big influx of Sylheti people and we had a big problem in that General Practices did not refer people with mental health problems from that community. In the eighties, we were the very first to set up a Bangladeshi counselling service and we trained somebody who spoke the language to run it, and then we did the same for the Somali community. There is a difficulty because some people think that a service by their own community is not as good as one provided by white healthcare professionals. We used the insights of the Bangladeshi and Somali counsellors  to help us to work with those populations.

Patients would sometimes talk to me about ‘those Paki bastards’ and I would always point out that this language was not acceptable. In my time, I saw a lot of people from the Bangladeshi community. I can remember one woman whose husband was a complete nightmare but culturally there was no way she could leave him. It was very hard to work with her because it was absolutely clear where her distress was coming from – it was from her relationship with her husband – but she could not alter that in any way. I could only offer her a place to talk about it and a place to consider other things that she might be able to do to improve her life, so that she understood she was not totally alone with her problem.

I did a lot of teaching of young doctors and medical students and I think – wherever in the world you are – you cannot overestimate sitting down quietly with someone and listening to what they have to say. Doctors who are always trained to do things find that very difficult to understand.

I joined the Jubilee St Practice in 1979 and I retired in 2009. I also worked in St Stephen’s Rd, Bow, in an all women practice which was unique in the East End at the time, when most doctors were older men. The working atmosphere at the practice was collegiate and they were very interested in the emotional life of their patients, which I think was unusual then. They looked after their staff very well.

I also worked in Wapping, where the GP had a bed with a pink quilt. I thought, ‘What’s this doing in the General Practice?’ In fact, it was where the GP slept when he was on call at night. He had his own bedroom at work. I observed the changing nature of the Wapping population. When the City people started to move in, they had much higher expectations and demanded to be seen when they needed to be seen.

There are a lot more children now with mental problems than when I started. There are multiple reasons. Not all children are in families where they get the nurturing that they need. Diet has a bit to do with it too. We could talk about air pollution. A lid used to be kept on by quite severe discipline. In general, children are much more disturbed now than twenty years ago. Families are much more disconnected with less extended families.

Over thirty years in the East End, I saw a major improvement in health services. District nursing and health visiting was of a very high quality in Tower Hamlets. The great thing about the East End was that it attracted people who are creative and want to improve health care. Every healthcare professional who has worked in Tower Hamlets and moved on still talks about working in the East End because there was a tremendous sense of collaboration and the patients were inspiring – because life was not easy for them.

I had a fantastic career, I was so lucky. Every year, the Bengali services had a Disability Awareness Day at Swanlea School in Whitechapel. The Bengali Disability Council set it up and they presented me a wonderful plaque for my services to the Bengali people of Tower Hamlets. That was the most moving occasion I have ever experienced. I got the MBE for services to healthcare in East London too, but the other award meant more to me because it meant I had been accepted by the community.”

Mary with former colleagues at the Jubilee St Practice

Mary Burd, Clinical Psychologist

Photographs copyright © Sarah Ainslie

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