Forty-five years ago, in June 1981, an influential documentary was aired on ITV. Silent Minority, directed by Nigel Evans, was filmed at two long-stay hospitals in England: St Lawrence’s Hospital in Caterham, Surrey, and Borocourt Hospital near Reading.
In just under an hour, Silent Minority showed what life was like for residents at these understaffed, underfunded institutions. Patients of all ages and disabilities were shown, including some who had been admitted as children as young as five and kept there for their entire lives. As one lifelong resident put it: “We look at each other, and watch each other get old.”
Neglected, disruptive children
Some of the most affecting footage from St Lawrence’s involved the children’s ward, where neglected and unstimulated children were left to amuse themselves for hours on end. The only means of getting attention from the few staff was through increasingly disruptive behaviour, something that infamously resulted in one boy, Nicky, being tied to a post for up to five hours a day.
Residents at Borocourt were similarly shown abandoned all day in a secure outside compound (donated by the Friends of Borocourt Hospital). Here, they hit out at each other, undressed themselves and exposed their skin – rendered extra sensitive from being given the antipsychotic drug chlorpromazine – to the unforgiving sun. They occasionally attempted to escape.
However, the enclosure was preferable to the shuttered seclusion rooms, where one patient was reportedly kept in solitary confinement for six months.
Silent Minority was careful not to criticise the nursing staff, choosing to highlight the intolerable situation in which they found themselves. Portrayed as caring people broken down and demoralised by the system, they were shown facing the exhausting everyday tasks of bathing and feeding scores of patients and having no time to interact with them on a meaningful basis, acting as custodians rather than caregivers.
This, the narrator tells us, is how society has told learning disabled citizens how they should be treated: shut up in long-stay hospitals for decades, while their behaviour and ability to interact with fellow humans inexorably declined.
Residents were shown abandoned all day in a secure outside compound, However, the enclosure was preferable to the shuttered seclusion rooms
The film instead levelled criticism at the government for its persistent claims that patients were receiving specialist care as well as at newspapers directing readers’ vitriol towards nurses “without ever questioning the system in which we ask them to work”.
The film juxtaposed the malign effects of the impersonal long-stay hospitals with the work of Malcolm Jones at the Spastics Society’s Beech Tree House (the charity is now called Scope). This small unit for learning-disabled children and adolescents with problematic behavioural issues provided one-to-one care and attention.
Jones argued this setting improved behaviour so much that residents could one day rejoin the outside world and become useful members of society. In contrast, he argued, the long-stay hospital exacerbated and entrenched disruptive behaviour to such an extent that patients were never judged fit to leave.
1981 had been declared the International Year of Disabled Persons by the United Nations, with an emphasis on “full participation and equality” between learning disabled persons and their fellow citizens. Silent Minority showed an appalled public just how far Britain was from this vision.
The impact of Silent Minority was significant. The outcry was such that questions were asked in parliament. While the government response was predominantly defensive, with claims that the film misrepresented life in long-stay institutions and the level of NHS care, ministers conceded the film had caused an outpouring of “genuine compassion and concern”.
As a result, moves to close long-stay hospitals were accelerated: the care in the community green paper was published that year.
Further reading
- Evans N. Silent Minority. Documentary. 1981.
- Firth G. “Silent Minority” TV documentary … the 40th anniversary. Connecting with Intensive Interaction. 9 June 2021.
- Hansard. “The Silent Minority”. HC Deb, 29 October 1981, vol 10, cc.452-4W.
