‘Up on Housing Project Hill, it’s either fortune or fame …’ 
Amidst the bustling if battle-scarred banlieux of South London, where generally I may be found, beating my barrel and pestering the passing populace, I observe that you can scarcely throw a brick across the grounds of a psychiatric hospital without it breaking the window of a luxury flat that’s popped up, seemingly out of nowhere, to grace what once were the rolling parklands of those asylums that of old delineated the darkness at the edge of town.
A périphérique, if you will, of places for the kettling and containment of worklessness and fecklessness and other invented psychosocial ailments – near enough to the capital’s centre, as Foucault taught us, to be projected into; far enough outwith the city walls to manage the fear of contamination.
Now that London has expanded its perimeter to the point that the M25 is the new South Circular, numerous White men in waistcoats have not been backward in coming forward to point out just how expensive land has become in what once was the outer rim and now is the ‘Zone Two/Three’ inner doughnut around the central hole of the capital.
What a lucrative and slam dunk, sure-fire winner of a business model Mental Health Trusts of various descriptions could be on to, these good people proposed, if they were to dismantle the old asylum buildings (think ‘spacious’, not to say ‘spreading’) and sell off the land to the pseudo-sanitised corporate fronts of offshore money-laundering syndicates, falling over themselves in their rapaciously desperate urgency to build de luxe apartment blocks where once walked wardens (think ‘atmospheric’, ‘historic’, ‘vibrant’, ‘cutting edge modern amenities – crèche, gymnasium, underground car parking, ECT suite, Clozapine Clinic – all thrown in’).
Ever mindful – in their own particular and peculiar, one-eyed fashion – of what we have come to know as the ‘optics’ (and never ones to miss out on a good bit of spin if the price is right), I hear in my imagination those mocca-chino’d money-men also murmuring that there could even be new-build hospital units in the mix, if the Trust executives played their cards right. More compact, of course – smaller footprint and none of your old-school sprawl – but (you know the tune: you could hum it for me, I’m sure) perfectly formed, purpose built, fit for purpose, COVID-secure, environmentally-friendly, hybrid conferencing facilities: all the trimmings.
Look at it this way (quietly they insinuated, over their flat whites and macarons): who’s going to argue with luxury flats, if the pay-off is air-conditioned consulting rooms with anti-barricade locks, and flat-screen technology you could open a pub with?
Well, I mean to say, I ask you: what’s not to love?
Now I don’t know if you the reader have ever previously come across the phrase “you can’t argue with luxury flats”, but I’ve heard it so often now that I have started to hear it as something a lot closer to an actual instruction to desist than an arch and knowing nod to the Zeitgeist, or a sort of pallid Stoicism about the common sensical and inexorable nature of it all. I rather fancy that before you can so much as mumble ‘antinomianism’ to yourself, La Cruella and her squalid band of cheerleaders will have made it illegal to ‘argue with luxury flats’ under some obscure but nakedly violent sub-clause of the Policing Act.
Cue a nation of nodding dogs, remarking sagely that ‘they must know what they’re doing’ or ‘someone must want to live there’ or ‘you can’t stop progress’ or ‘bringing service delivery into the twenty-first century’ – well, you know the sort of thing …
I do nonetheless feel moved to argue with luxury flats – and with hospital new-builds, their deniable and spurious offspring. I am positively hissing, in fact, and I would proclaim my pissedness from the rafters, if only the bulldozers had left any rafters (for afters). If indeed it is, any second now, about to become against the law to argue with luxury flats, then the Home Secretary may do her Braver worst. My barrel is easy enough to find and open to all elements, desirable or otherwise – no need for an anti-barricade lock here …
I will argue with luxury flats, and here’s how:
To begin with, we must note that this land has been NHS land since the 1940s, and once it is gone, it is never going to be possible to get it back again. First, we pave the parklands, then we put up a parking lot and contract it out to make fortunes for cowboy enforcers while deterring visitors to the site; then we wash our hands of the well-being of future generations altogether. Instead of blocks of privately-owned flats encroaching inside the agora boundary-stones of NHS hospital grounds, before we know it, there’ll be nothing but little outcrops of outpatient clinics engulfed by housing estates.
Examples abound (and I’m not going to name current names), but Exhibit One, m’lud, is the old Henderson Hospital site in Sutton – the building that housed the Democratic Therapeutic Community there for nearly half a century (after it eventually moved there from Belmont) was dismantled brick by brick and carted off, and now the only evidence of a system of health and social care is a shiny new GP practice, where, no doubt, post-austerity and COVID-19 and Brexit, you can’t get an appointment with a human being at any price.
Privatisation, to put it simply, means deprivation, whichever way you slice the cake. You could resource new hospitals without selling off land to developers: it’s called funding a national health service, and it only takes, say, sending a handful of Challenger tanks a year back to BAE Systems marked unused and surplus to requirements (at £5,400,000 a pop and change – or approximately the equivalent of the yearly saving that would come from the Government not spending any money on legal fees defending bullying or sexual or financial misconduct complaints against MPs and cabinet ministers).
Now I don’t wish it thought that I fume and fulminate out of some faux or toxic nostalgia for the ‘back wards’ and abuses of the old asylum system – nor indeed for the dilapidated nursing barracks that have accommodated outpatient and inpatient care in many of these places. But those open spaces mattered, were balm for the soul. There’s no therapy quite like sunlight through the trees, bird song and fox bark and the snail on the leaf.
You’d think that the architects (in both senses of the word) of the new-builds would have learned the value of this even as they drew up their plans to dig up the grasslands, but no! It can’t be monetised, so it doesn’t count. There’s nowhere now to walk except on pavements or parking lots, ‘outside’ spaces are now landscaped inside the new-builds – on artfully constructed roof gardens or enclosed courtyards – and of course you can’t actually open any of the windows in these buildings, for ‘health and safety’ reasons.
I also get it that there really is a housing crisis in the London area and that some of the new blocks that have arisen from the rubble of Victorian outpatient departments are designated ‘affordable’. Forgive me though while I quietly choke on that word ‘affordable’ in this context. They’re not affordable to the local communities most in need of them – although they are affordable to that well-known engine-room of the British middle classes, the ‘Bank of Mum and Dad’.
As for the ‘luxury flats’ – only money launderers can afford to renovate them and only money launderers can afford to buy them. Only time will tell whether anyone at all actually wants to live in them. The housing crisis will escalate regardless, since the structural factors creating homelessness and displacement are intensifying rather than abating and ‘luxury flats’ and gentrification generally are precisely an example and epitome of this.
So, marvel not, my friends, at these shiny hospital new-builds, for they rise from the ruins of excluded communities and marginalised ‘patient’ populations – and the ghosts of generations of sufferers howl wordlessly as they claw impossibly at the reinforced glass walls of that ostensibly inviting new atrium.
And don’t forget that inpatient mental ill-health beds are down 25% since 2010 and falling, in the context of a rising and increasingly unsettled population. One thing these new-builds are not is larger – and of course the land on which that bed capacity could be restored…has been sold for luxury flats. Whatever the merits and demerits of medical model inpatient care for psychosocial distress and disability – both in principle and in practice – the reality in South London is that most of the time an NHS psychiatric bed is not to be had when it’s needed – but still those bulldozers and money-launderers rampage through the foundation and fabric of the post-1945 welfare settlement.
Spare a thought also for the invisible cost in terms of the wellbeing and viability of the various and numerous community teams who have been repeatedly and seemingly endlessly displaced and unsettled by the shuffles and decants they have been put through because the land their offices previously stood on has been sold for luxury flats. Outreaching mental health practitioners need a secure base from which to explore, but their needs and by extension their patients’ needs are never factored in to these increasingly complex ‘chains’ of moving house and not infrequently there is simply no room at the inn at the end of the chain.
Let’s not overlook, either, that in South London, that means there is a dimension of structural racism to the question of who gets valued and who gets dehumanised in this property gold rush. Plus ça change …
If I come last of all to the actual service users invited into those alluring new-build atriums to take a seat in those shiny new waiting areas, it is not to overlook that ultimately it needs to be all about these our fellow-citizens or nothing has been gained – it is just that I don’t wish to ventriloquise and it’s not for me to say what might be another’s experience of such a welcome.
I will say what my worry is, as a ‘mental health practitioner’ myself. I was kidding you not about those anti-barricade locks. They are on every consulting room door in one particular new-build I have in mind. They cost upwards of £5000 per door. The ‘forensic’ non-throwable chairs will also set you back something nearer four figures than two. Not that you’d want to buy one in the first place. Or try to sit in one. Let alone throw one at the designer.
Construct our fellow-citizens as ‘other’; attribute, across the divide we’ve just randomly established, diseases of the mind which we’ve often just invented in our lunch-break; corral and kettle ‘them’ like so many fish in a fish farm; get affronted when ‘they’ become vociferous in their objection to being so toxically othered; put up a Lord Kitchener-type poster proclaiming that abuse will not be tolerated – and see where it gets us. That seems to be the game plan.
And that’s why luxury flats can be argued with.
‘… if you’re lookin’ to get silly/you better go back to from where you came…’
 The lines that open and close this blog are both from verse four of ‘Just like Tom Thumb’s Blues’ by Bob Dylan, from his 1965 album Highway 61 Revisited.
 The footnote indicator here is to mark that, while I hope this little piece may support the theory that irony is not yet dead, the reader must know that there is absolutely nothing funny about the suffering of the people for whom these last two interventions are generally intended, or more broadly about the psy-industrial complex and its instruments of social control.
 I am conscious in making these references that the shelf-life of UK Home Secretaries has lately been shorter than that of the most transient and flash-in-the-pan of weblog posts, so: blink and you’ll miss her, but Suella Braverman is the one we have right now. Be afraid: be very afraid.
 This idea about holding open the ‘agora’ or public spaces against privatising encroachments, and the perspective of this blog generally, draws upon the argument in my book with Christopher Scanlon ‘Psycho-social explorations of trauma, exclusion and violence: un-housed minds and inhospitable environments’ and if some of this is of interest you can read Chapter Two open access via this link: https://www.routledge.com/Psycho-social-Explorations-of-Trauma-Exclusion-and-Violence-Un-housed/Scanlon-Adlam/p/book/9780367893316
 You’ll appreciate that I am using the term ‘money laundering’ in a broader than usual sense, to include asset-strippers and climate despoilers of every description.