Earlier you said that your convalescent home was like a concentration camp, will you tell me what you meant?

In 1952, eight-year-old Royston was admitted to a convalescent home for two months while he recovered from surgery. He was one of the multitudes of children who were admitted to convalescent homes between 1845 and 1970. The great majority were working-class children who, it was believed, were in need of fresh air, good food and rest to recuperate from ill health and escape the corrosive effects of urbanization. Children’s institutional convalescence was part of a general mushrooming of voluntary healthcare provision that occurred during the nineteenth and twentieth centuries. Convalescent homes were sponsored by a range of individuals and organizations, but these can be broadly divided into six main categories: homes affiliated to a religious body; homes affiliated to a hospital; independently owned homes; homes owned by an existing charitable organization; local authority owned homes; and after 1948, National Health Service homes.

The motivations for establishing and sponsoring a children’s convalescent home varied between individuals, organizations, and over time. Sponsors were motivated by a number of factors that often coexisted, combining altruism, civic duty, religious obligation, self-interest and the objectives of the nation-state. As the motivations of sponsors evolved over time, so did the provision of homes. There were three cycles of expansion and contraction between 1850 and 1970, with two World Wars punctuating an overall pattern of growth between 1850 and 1955, followed by an eventual decline in the 1970s. Within each general growth cycle there were distinct differences in the growth patterns of various categories of homes. This reflected changes in the motivations of sponsors and their support for children’s institutional convalescence (Figure 5.1).

Despite the durability of their association with children’s healthcare, scholarly investigation of children’s convalescent homes is sparse. Typically, historians have tended to research innovations in child health through the provision of community-based welfare clinics, domiciliary nurse visits and school medical inspections. The residential healthcare of sick children has received limited attention.² Work by Harry Hendrick has begun the process of turning the focus of attention towards children’s hospitals.³ His work explores children’s experiences of hospitalization through medical case notes, doctors’ reports and official documentation; unfortunately, these sources do little to uncover the experiences of sick children.

Broader historical research on children’s residential institutions has demonstrated a wide range of provision and inmate experience. Much of this work suggests that these institutions shared a number of objectives. They sought to control and reform children who were perceived as problematic by society, including the poor, sick and disabled, commonly by their permanent removal from their familial homes.⁴ The dominant interpretation of children’s welfare institutions remains one of coercive, isolating and uncaring places, in which the discipline and punishment of children was often unnecessarily severe. Recent work has challenged this assessment and emphasized the extent to which regional contexts, subject populations and local officials varied the institutional experiences of children.⁵ Yet, despite this rich historiography, individual experience and day-to-day institutional policies and practices have too commonly been overlooked.

Since Roy Porter’s call to study history from below, historians have turned to new methods of analysis to study the subjective experiences of the non-hegemonic classes and subaltern groups. However, the voices of child patients have remained persistently silent. This chapter uses the remembered experiences of institutional convalescence as a prism through which to view children’s subjective experiences of healthcare. The close examination of fifty-three oral history interviews with individuals who had been admitted to convalescent homes between 1932 and 1961 allows those who experienced convalescence to be the central figures of this chapter. All of the interviewees lived in the London area at the time of their admission and characterized themselves as coming from working-class families. They were admitted to twenty-four different homes for a variety of medical and social reasons, and they stayed on average for four months.

Alessandro Portelli argued that oral history requires specific interpretive instruments that are different to written sources.⁶ The method of interpretation deployed in this study was to undertake an intensive analysis of each interview using psychologist Carol Gilligan’s Listening Guide method.⁷ The Listening Guide is a way of analysing qualitative interviews, drawing on the clinical methods of Freud, Breuer and Piaget. It is composed of a series of sequential readings, or ‘listenings’, that allow the researcher to uncover the varying voices of an interviewee. The Listening Guide is composed of four steps. The first step listens for the plot and the researcher’s response to the interview. The second listening focuses on what the Listening Guide calls the ‘I’ voice, by following the use of this first-person pronoun, and constructing an ‘I poem’. I poems pick up on an associative stream of consciousness carried by a first-person voice running through a narrative, rather than being contained by the structure of full sentences. In some cases, an individual’s I poem illuminated a theme that was not directly stated by the interviewee, but was central to understanding what was being said. An example of this can be seen in an extract from the I poem of Chris, and sheds light on why he repeatedly absconded from his convalescent home, even though he was considered to be a mature, sensible child. Chris was admitted to a home for four months in 1950, when he was ten years old.

The third step of the Listening Guide is shaped by the specific questions guiding the research. During this step, each transcript was read and simultaneously listened to, observing for a particular strand, or voice of the interviewee’s remembered experience. Gilligan described this as listening for ‘contrapuntal voices’. The final step of the Guide pulls together what has been learnt about the interviewee into a single analysis that can be used alongside their transcript. Taken as a whole, using the Listening Guide method facilitated a comprehensive analysis of all of the interviews that accommodated an awareness of subjectivities and composure of self-narratives.

Colin’s I poem illustrates that careful analysis of oral history testimonies can deepen our historical understanding of children’s dependence and interdependence and how they exercised agency in a diversity of ways. By considering the various ways that children enacted agency, this chapter complicates institutional narratives that identify children as homogenous, subordinate subjects. Instead, it positions children’s agency as shifting, negotiated exchanges shaped by age, context, relationships and cultural norms. Concepts of agency were conceived to account for the behaviour of adult, usually economically privileged, white males. Positioning children as independent social actors challenges historians to reconceptualize and broaden their definitions of agency. Mary Jo Maynes has observed that many of the ordinary understandings of agency and power simply do not apply to children.⁹ She suggests that by critically engaging with definitions of agency, the importance of age as a category of historical analysis comes sharply into focus. In problematizing definitions of agency, this chapter rotates around the key foci of privacy and discipline. The first section explores the various ways in which institutional practices challenged children’s privacy and provides a unique view of the cultural constructions of privacy. Children enacted privacy norms by deploying various behavioural devices to maintain their privacy; this provides valuable information regarding the significance of age to agentic behaviour. The second section examines discipline within children’s convalescent homes. The institutional discipline of children who, for the most part, were not perceived as problems, provides a deeper understanding of social attitudes towards discipline than is available from current scholarship’s focus on delinquents. The different modes of discipline used within convalescent homes, and their varying influence on an individual’s ability to exert agency, draw attention to the pernicious effect of isolation within institutional settings.

Privacy

Historians have recently begun to pay attention to the place of privacy in history. Their scholarship has emphasized the experience of adults and we know very little about the meanings of privacy to children.¹⁰ A richer body of scholarly work in the field of child psychology has addressed the privacy requirements of children.¹¹ Psychologists have suggested that how children conceptualize privacy increases in complexity with age and an associated growing appreciation of themselves as social objects.¹² In their oral history testimonies, respondents’ understandings of childhood privacy, and the extent to which it was met, challenged or encroached upon was strongly influenced by their age at admission. However, there was not an age-related linear progression of privacy needs, moving from low to high. Instead, there were often seemingly contradictory representations of childhood privacy, particularly in the areas of toileting, bathing and emotional privacy. By exploring each of these areas in turn, it is possible to observe the complexity of children’s privacy needs, and the extent to which age, context and relationships combined to influence an individual’s experiences and perceptions.

Attempts to maintain their privacy in the lavatory featured in the narratives of the great majority of interviewees. All of the interviewees were continent and able to use the lavatory independently at the time of their admission. Their familial homes had a variety of facilities consisting of: single household with outside toilet (28); single household with inside toilet (11); shared toilet with one other family (7); shared toilet with two other families (5); shared toilet with more than two other families (2); and a communal pot or bucket for night time use only (33). These various facilities were understood to be normal by respondents and usually only mentioned in response to a direct question. Conversely, lavatory facilities in convalescent homes and the difficulties they experienced maintaining personal privacy during elimination were proactively mentioned by eighty-seven per cent of respondents.

Their statements draw attention to a set of generalized, age-specific institutional regulations that governed children’s behaviour in the lavatory and inhibited the amount of privacy they were allowed. Individuals aged seven years and under at the time of their admission recalled that they were required to use a potty, rather than a lavatory. Between the ages of eight years and eleven years, children were permitted to use the lavatory, but were required to leave the door open and were closely supervised by staff. Children over the age of eleven years were permitted to shut the door, but not to lock it or flush the toilet. Older children were also required to gain permission from staff before going to the lavatory and request paper if required. Interviewees believed that these requirements challenged not only their need for privacy, but also their sense of maturity and their age-related identity. Typical in this regard were the experiences of Anthony and Bertha.

In common with all interviewees who recalled episodes in which their privacy was challenged, Anthony and Bertha narrated their experiences in the voices of despondency and anger. However, thirty-one of the respondents also recalled behaviour in which they sought to regain their privacy and exert control over their environment. When narrating these episodes, the voice of confidence came to the fore. The following extract from the testimony of Mavis illustrates the contrapuntal motion between the voices of despondency, anger and confidence. The counterpoint between these three voices demonstrates the complexity of children’s agency. In many instances it was the emergence of the voice of confidence that drew attention to agentic behaviour that may have otherwise been overlooked, as it frequently did not conform to adult patterns of behaviour. Mavis was admitted to a convalescent home for six months, suffering from tuberculous glands and weight loss.

Mavis’ testimony demonstrates that children’s agentic behaviour differs to that of adults, and may be embedded within other activities, including play. Sociologist William Corsaro has shown that children use play to both reinforce and subvert institutional rules, and, like Mavis, use communal play as acts of subversion and to build peer culture.¹⁶ These modes of behaviour were also observable in the testimonies of older children, although they tended to deploy increasingly sophisticated modes of agentic behaviour. An example of this was the ‘fainting game’ recalled by Saul, in which a child distracted nursing staff by holding their breath and pretending to faint, thus allowing other children to ‘sneak in [the toilet] without being seen’ by nursing staff.¹⁷ This game is interesting because there was an acceptance that not all of the participants would immediately receive the benefit of privacy, and children ‘took turns to faint’. The complexity, trust and protracted nature of the fainting game demonstrates both the cohesiveness of peer group culture built through play and the degree to which peer group relationships supported autonomy and subversive resistance to authority.

Memories of play acts indicate that individuals used play to confront confusion and fears generated by institutional rules. Nine of the older children recalled singing or speaking very loudly to let staff and other children know that they were in the lavatory, or placing jumpers over their knees to ‘preserve [their] modesty’.¹⁸ This is what Corsaro calls a secondary adjustment, in which children use legitimate resources in artful ways to get around rules.¹⁹ Interviewees who were approaching adolescence, although given the greatest amount of privacy, adopted the most direct approaches in securing their privacy. However, this was never overt confrontation with staff; instead, artfulness or deceit were commonly employed. Pam was admitted to a convalescent home for three months for the treatment of her ‘nerves’. In her interview, she described her feelings of embarrassment and how she avoided asking for toilet paper.

Respondents’ testimonies indicate that they understood themselves to be active participants in securing their privacy, but they exerted their agency in many different, distinctly age-specific, and often oblique, ways.

New and different patterns of age-related behaviours were observable when children sought to maintain their privacy during bathing. Only eight respondents’ familial homes had bathrooms; the great majority recalled a tin bath pulled into the kitchen and filled with water. Over ninety per cent of respondents recalled bathing at home between once and three times a week; only three respondents remembered baths as being rare events. For younger children, bathing was usually a communal activity with similar-aged siblings or even cousins. In some cases, this would be with members of the opposite sex, but in most cases there was strict sex segregation. Sharing a bath with parents was unusual. Only six individuals remembered sharing a bath with their mothers, while no interviewees remembered bathing with their father.²¹ The practice of communal bathing stopped well before puberty, usually around the age of ten years, after which strict routines of privacy were enforced. These routines prevented family members seeing each other’s naked bodies, regardless of relationship or sex. Typical in this regard was Ron’s belief that his own mother did not see him ‘without any clothes from roundabout ten years old’. Donna remembered getting undressed in the bedroom that she shared with her five sisters as being ‘like doing the dance of the seven veils’, as they all sought to preserve their modesty.²²

It was from within the context of strictly enforced codes of bodily privacy in their familial homes that forty per cent of respondents recalled nudity during bathing in convalescent homes as the most significant deprivation of their privacy, as judged by the number of times it was mentioned and the level of emotional distress recalled. Familial bathing routines were often held in contrast to the institutional nature of convalescent home bathing. But it was only respondents who had been older children, and had stopped sharing baths with their siblings, who believed that their privacy was intruded upon and objected to bathing with their fellow patients. The memories of Annie and Paul illustrate how they both found the bathrooms in their convalescent homes strange, but only ten-year-old Paul objected to sharing a bath with his fellow patients.

Annie’s and Paul’s testimonies demonstrate how privacy associated with bathing was age-dependent, and influenced by normative behaviour from respondents’ familial homes. Older children who were accustomed to bathing separately viewed their bodies as private and personal. Consequently, they expected more privacy than younger children who were accustomed to bathing with their siblings or cousins. Unlike other areas in which respondents tended to assert their agency in oblique, non-confrontational ways, when maintaining their privacy in the bath, respondents were more likely to directly refuse to comply with staff requests. This may reflect the older age of this cohort, who were all over ten years of age, but their testimonies also indicate that it reflected deeply held beliefs that their bodies were private and should not be exposed to others. These beliefs were articulated in the voices of anger and confidence, and demonstrated by the I poem of Penny, who was admitted to a convalescent home for two months in 1958, at the age of eleven years.

Simon Szreter and Kate Fisher have demonstrated the enforcement of strict codes of bodily privacy by English working-class parents during the first half of the twentieth century.²⁶ They also note a gradual relaxation of inhibitions between some mothers and their young children in the post-war years, an assessment also supported by the memories of six post-war respondents who bathed with their mothers as very young children. It is interesting then, that the interviewee statements examined for this chapter suggest that codes of bodily privacy governing pre-adolescent and teenage nudity were consistent across the period of study. This suggests that although attitudes to adult and younger children’s bodies relaxed, attitudes towards the adolescent body and nudity were enduringly conservative. This observation supports the works of historians who argue that adolescence was viewed as a point in the life cycle associated with psychological turmoil, potential ill health and moral danger.²⁷ This historiography has tended to emphasize attitudes towards adolescent girls, but evidence from interviewees’ statements indicate that the bodies of adolescent boys were considered to be equally at risk.

On the other hand, the oral history testimonies presented in this chapter also indicate that understandings of children’s bodies, bodily functions and associated privacy needs were more complex than can be accommodated by adopting an adolescent watershed model. The age-related privacy codes associated with bathing were at odds with the uniform expectations of privacy during toileting; the inconsistencies in expectations between these two contexts suggests that privacy codes did not simply correlate linearly with age, but rather, were age and context specific.

Memories of diminished privacy did not only relate to individuals’ physical bodies; they also incorporated the need for psychological privacy. Scientific research has indicated that children’s desire for psychological privacy is linked to their developing sense of themselves as individuals, and a need to achieve psychological autonomy by separating themselves from the people and things in their environment.²⁸ Consequently, although many respondents described the institutional environment and regimes as oppressive, only respondents who were over the age of eleven years at the time of their admission recalled wishing for psychological privacy. These respondents emphasized the erosion of their agency by strict daily regimes and their confinement within the authoritative boundaries of homes. The physical boundaries of convalescent homes were shaped by walls, gates and other barriers that limited children’s freedom of movement and confined them within the institutional sphere of authority. This was at odds with the daily experiences of the majority of older patients who recalled playing freely in the streets around their home and in local parks. Mathew Thomson has noted that the culture of outdoor urban freedom continued into the later twentieth century. Pam contrasted the extensive freedom that she was permitted by her parents with the strictly controlled environment of the convalescent home.²⁹

In remembering the fencing, walls, gates and barriers of their convalescent homes, respondents demonstrated a present-day understanding of their purpose, stating that they ‘were probably there for safety reasons’, ‘to stop small children wandering off’, and to deter ‘unwelcome visitors’.³¹ Nonetheless, they clearly differentiated between their current understandings and their past feelings of confinement. Thus, the physical boundaries and strict daily regimes, like those described by Pam, prevented children from having time and space in which they were free from supervision. In her study of Australian orphanages, Shurlee Swain noted that children created private spaces in a variety of ways, often breaking or circumventing rules to escape the institutional gaze.³² A similar pattern of exerting agency was described by the older children in this study, who recalled diverse ways in which they created private spaces in the supervised world of convalescent homes. Brenda described how, as an eleven year old, she would hide in her dormitory, and ‘wait for all the other children to leave’, so that she could ‘just be relaxed and daydream’.³³ John recalled making a ‘forbidden climb’ into the branches of ‘an old tree and looking over the [convalescent home] wall’, when he felt the need to be alone. Maurice also remembered climbing a tree, but he used the tree as a means of hiding ‘out of sight, away from staff and watch[ing] what everyone was doing’.³⁴

As well as exerting agency by breaking rules, six respondents also used compliance with institutional regimes as a means of achieving a private space. Jean described how she volunteered to help the nurses put away blankets so that she could ‘dawdle, do what I wanted, my own thing’.³⁵ In this way, some children’s compliance was an act of agency, as they consciously adopted behaviour patterns to exercise control and achieve their objectives. Boys and girls were equally likely to use compliance as a means of achieving their objectives, and similarly, both sexes broke rules to achieve privacy. Both modes of behaviour were narrated in the same contrapuntal voice of confidence; moreover, the emergence of the voice of confidence identified continuity of meaning in otherwise disparate and complex behavioural patterns.

To evade institutional surveillance and maintain their privacy during toileting and bathing, and to achieve emotional privacy, children frequently exerted their agency in ways that were oblique or contradictory or did not conform to traditional understandings of agency. Exploring interviewees’ understandings of childhood privacy, and how they sought to maintain this in different situations, has demonstrated the influence of age, relationship and context on both their privacy needs and how individuals responded when these were challenged. The importance of these three factors in mediating children’s responses and their ability to exert agency was also present in their experiences of discipline within convalescent homes.

Discipline

The constant surveillance experienced by children in convalescent homes, and the associated threat to their privacy, was part of a more generalized scheme of control and discipline that shaped their daily experiences. British attitudes towards the precepts and practices of disciplining children have been the subject of a varied and valuable body of historical research.³⁶ Despite this rich and varied historiography, inmate experience and the day-to-day nuances of institutional policies and practices have too commonly been overlooked.

Children of all ages described episodes of discipline in which rules were enforced by nursing staff. In seventy-nine per cent of such cases, respondents characterized their experiences in predominately benign terms. This was especially so when rules were familiar to them and the actions of staff reflected their previous experiences of discipline. As such, most experiences of discipline were not conceived as remarkable or particularly different to that of their familial homes, schools or clubs. Some of the commonly cited examples of benign discipline included rules, such as no running in corridors, no fighting, no pushing, and taking medicine. In most instances, children acquiesced to these rules with no or minimal resistance. Typical in this regard was Patricia who described the daily administration of iron tablets.

In common with other individuals who recalled these events as relatively minor, Patricia’s characterization corresponded with experiences in her familial homes where taking medicine was a negotiated exchange in which she ultimately complied. Familiarity of experience appeared to increase the acceptability of rules, and Patricia considered the administration of medication in this way to be acceptable, believing that it was the ‘job’ of nursing staff to ensure children took their medicine.

The rule that interviewees recalled contesting most frequently was the requirement to eat all of the food that was served to them. The majority of respondents described the rule being rigidly enforced in their convalescent homes. Chris recalled that staff ‘made a big hoo-hah and song and dance about it, if you dared to leave anything on your plate’.³⁸ However, resistance and refusal to eat unwanted food were relatively common. As Helen’s memories suggest, resistance was frequently covert.

In addition to acts of covert disobedience, interviewees recalled engaging with benign discipline in ways that reflected their non-institutional behavioural patterns, including using play, singing and acts of daring that were intended to ridicule and subvert rules. The memories of Dorothy and Michael were typical in this regard.

Did the nuns know that you sang songs about them?

Dorothy and Michael demonstrate the way in which various acts of agency were political in building peer culture. This was not unusual and interviewees’ recollections of benign discipline and how they engaged with such discipline were consistent across the period covered by interviewee experience.⁴² In their classic study The Lore and Language of School Children, Iona and Peter Opie noted that parody and acts of daring were ways that mid-twentieth-century children exerted independence without having to rebel.⁴³ Correspondingly, although interviewees recalled regularly subverting, or attempting to subvert, benign discipline, they simultaneously described complying with rules with minimal enforcement by staff and without any sense of distress. This was the case for Paul, who recalled that he was treated in a ‘firm but fair way’, and that ‘there was loads of kids, so they needed to keep us under control, but they were kind ladies, and they didn’t mind if we larked about a bit’.⁴⁴

Despite most respondents recalling that their acts of disobedience were covert and that they eventually acquiesced, in many instances their behaviour also represented powerful examples of agentic behaviour. Rule breaking was not a purely personal action; it built peer culture and increased the political power of individuals within their peer group. This was the case for Frank whose memory of defiance elevated his status among his peers.

Acts of rule breaking that involved an element of daring were important in respondents’ conceptualization of their own agency and power. As demonstrated by Frank’s memory of becoming ‘the King of the Castle’, he was clearly aware that his childhood self had exerted political power, even though as an adult, he believed the act to be a ‘silly experience’.

Just over thirty-five per cent of respondents recalled that they complied with rules to achieve an alternative objective. Chris described how by acquiescing to his weekly laxative medication, he used other children’s resistance to his advantage.

In narrating accounts of compliance and receiving some form of advantage, the voice of confidence came to prominence. In this way, some children’s compliance was an act of agency, as they consciously used their consent to treatment as a form of exercising control. Moreover, for these children, giving their consent to an unpleasant treatment actually increased their sense of power and control.

Interviewees’ recollections of benign discipline and the ways in which they engaged with such discipline was consistent across the period covered by interviewee experience.⁴⁷ Although resistance to rules was relatively common, accounts of physical punishment by nursing staff were very rare, with only three cases described by respondents. In comparison, ninety-six per cent of interviewees described receiving physical punishment from their parents, and seventy-two per cent recalled physical punishment as a common form of discipline at school. Low levels of physical punishment in the homes suggest an atmosphere of relative tolerance. There were, however, a significant number of events in which staff used humiliation as a form of discipline. Most of these events involved episodes of incontinence, usually nocturnal enuresis.

Historically, attitudes to nocturnal enuresis were intolerant, and punitive measures were believed to be an effective treatment.⁴⁸ Interviewee experiences reflected prevailing beliefs and attitudes, and many recalled ‘treatments’ that involved public shaming, washing their own sheets, having their noses rubbed in wet sheets and being left with wet bedding or in wet clothes all night. The testimonies of Jean, Rosamund and Annie reveal the strength of trauma experienced from such humiliating punishments, and provide poignant witness to its lasting effect on individuals.

In total, nine respondents recalled being punished for nocturnal enuresis; their ages ranged from six to eleven years old. As with other accounts of discipline involving humiliation, interviewees articulated a sense of injustice at their treatment. Their accounts were narrated entirely in the voice of despondency, frequently exhibiting signs of discomposure, moving backwards and forwards between events and in chronology. In recalling accounts of humiliation, respondents appeared to have been overwhelmed by their experience and unable to exert a sense of agency or power. Children’s lack of agency was related to an overwhelming sense of isolation caused by humiliating punishments that divided them from their peers and undermined any sense of control. The following extract from the I poem of Martin recalls the experience of lining up to have his underwear inspected for marks, and demonstrates that in certain circumstances children appeared to have very little agency.

The total absence of power in Martin’s account was typical of individuals’ memories of discipline that involved humiliation – even among respondents who recalled acts of agency in other circumstances. Whereas, in most forms of agentic behaviour interviewees recalled building and drawing on support from peer culture, this support appears to have been dissolved by humiliation. In their studies of boarding school children, Vyvyen Brendon and Joy Schaverien have noted similar feelings of helplessness associated with humiliating punishments.⁵³ W. R. Meyer’s study of day-pupils in Leeds has demonstrated that teachers who humiliated pupils were ‘likely to lead to umbrage taking and protest’ by parents.⁵⁴ This indicates that pupils informed their parents about humiliating punishments, and, as such, they exerted agency through their familial support network. Hence, the prolonged physical separation of children from their families in convalescent homes combined with the isolation caused by humiliating punishments rendered interviewees unable to challenge certain forms of discipline, even when they perceived them to be unjust.

It is, then, significant that, in common with boarding schools, children in convalescent homes were separated from their families by distance and restrictive visiting practices. The continuation of restricted visiting by homes and the prolonged separation of children from their parents is at odds with the practice of children’s hospitals that, influenced by John Bowlby’s and James Robertson’s work on maternal separation, had generally introduced daily open visiting for parents by the mid-1950s.⁵⁵ The explanation for the marked difference in policies between hospitals and homes is unclear, but entries in official records continued to stress the importance of providing children with fresh air, good food, rest and respite from the overcrowding and pollution of London, without discussing their emotional well-being. The primacy afforded to physical health over mental health points to an area of tension in children’s healthcare, where new concepts and understandings of children’s emotional needs and child psychology collided and competed with traditional ideas of childcare and medicine.

Conclusion

As part of broader schemes of welfare reforms, children’s healthcare provision changed during the mid twentieth century from that of a mixed economy of philanthropic and local authority sponsored endeavours to a central government sponsored National Health Service.⁵⁶ Yet, throughout this transition, institutional convalescent care for children was an enduring and accepted part of medical orthodoxy. Although aspects of children’s convalescent care were often conceptually dynamic, the day-to-day experiences of child patients were remarkably stable throughout the nineteenth and twentieth centuries. This demonstrates that new understandings of child psychology did not permeate all areas of children’s institutional care.

Interviewees’ testimonies revealed that the significance of children’s convalescence extended beyond its role in consolidating biological recovery, and generated acute and often long-term emotional responses. Enmeshed within interviewees’ narratives were a number of events relating to toileting, bathing and discipline that occurred over and over again, from one interviewee to the next. The significance of these events to an individual was clear to observe. Their diffusion through the majority of testimonies indicated that they were essential to our understanding of children’s experience of convalescent homes and institutional care more broadly. What was less clear was how a group of disparate events were related. An analysis of interviewees’ testimonies using Gilligan’s Listening Guide demonstrated that what appeared to be separate events were a chain of remembered experiences in which interviewees exerted or attempted to exert agency. The varying ability with which individuals exerted agency draws attention to the importance of age, context and relationships in children’s ability to exert power.

Through the themes of privacy and discipline, it has been possible to interrogate episodes of childhood agency within an institutional setting. Children’s power in their relationships with adult carers cannot be explained through a binary of adult power versus child resistance. Instead, children exerted agency in a myriad of ways, including negotiation, resistance, compliance, play and peer group activity. Moreover, respondents’ testimonies indicate that they understood themselves to be active participants in exerting autonomy, but they exerted their power in distinctly age-specific ways that do not conform to many of the ordinary understandings of adult autonomy and power.

Resistance or compliance with institutional regimes was directly related to children’s experiences in their familial homes. Experiences that were familiar to children were more likely to be complied with. Conversely, practices that were unfamiliar or perceived to be unjust were frequently resisted, albeit often covertly. And practices that contravened privacy norms were likely to be overtly resisted, particularly when associated with adolescent and pre-adolescent nudity. Although most memories of resistance were covert, they often represented powerful agentic behaviour by building peer culture and individual status. Peer groups were an important site and medium of childhood agency across the period covered by interviewee experience. However, disciplinary methods employed by staff that involved the use of public humiliation appear to have dissolved peer group support and resulted in a corresponding absence of agency. Respondents’ memories draw into focus the pernicious effect of isolation and underscore the detrimental effect of the physical separation of children from their families. The significance of this observation extends beyond the study of children’s convalescent homes and points towards broader experiences of children’s institutional care in historical and contemporary settings.

For historians, the need to engage with subject populations on their own terms is a well-established tenet. However, the challenge for historians of childhood is to use methodologies that capture meaning that may be obscured by an adult-centric bias. While historians of gender, race and sexuality have done much to extend definitions of agency, questions of how children historically enacted power require yet further discrimination. Indeed, the oral history testimonies examined in this chapter suggest that there is not a single model of childhood agency; rather, there are many agencies that are age-specific, relational and contextual. As such, it is necessary for scholars to think about age in more complex ways, beyond the static or linear categories of childhood and adulthood.