This research started with a response to a call for papers for a conference on the history of television and health and involved an investigation into the provenance of a 16mm film copy of a BBC programme on venereal disease (VD), donated to Wellcome Collection by the family of Francis (“Frank”) St. Dominic OBE (1928-1996), a well-regarded health educator.1 This article explores how enthusiasm developed for TV within public health in the United Kingdom and how TV, in turn, tentatively embraced health issues, driven by ‘enthusiasts’ from both sectors. The historiography of TV broadcasting to schools lacks detail and so this archival research endeavours to address this by giving an insight into the advisory process behind-the-camera.2
My role as a research development specialist at Wellcome Collection leads me to focus on the hidden narratives behind our collections, going on a research journey to find, then make sense of the absences and omissions in the archival record to activate these collections. The research path led beyond Wellcome Collection to the programme file at BBC Written Archives, which had not been consulted by researchers since the programme had aired.3 The file first had to be vetted prior to consultation. It turned out to be a substantial production file (an unusual happenstance corroborated by fellow historians) with memos, documents (plentiful background literature published at the time in the form of VD education leaflets, often ephemeral and patchily retained in archives and correspondence), and letters. Subsequent research in Wellcome Collection revealed that some of the published sources contemporary to the programme are vague in referencing the ‘Health Hazards - VD’ (1973) episode of Twentieth Century Focus specifically. One example is Peter Goodchild in 1976, editor of the highly regarded science BBC TV series Horizon, choosing not to mention the programme by name, but referencing its non-didactic, non-judgmental approach that was “very conventional in programme-making terms but made with sympathy and care. […] such a straightforward approach is valuable. With this special audience a straightforward approach has been valued enormously.”4 This is important to note in managing contemporary expectations regarding the production aesthetic of schools programmes versus their critical success at the time. Another key resource was the BBC Genome Project and the transcription of TV listings from historical issues of The Radio Times which proved invaluable in tracking the career of the series producer, Gordon Croton, from radio to TV. Furthermore, the rich resources at Wellcome Collection, holding the only extant copies of relatively recent published works by many of the contributors from the 1970s, revealed a network of connections whereby each cite the other in their work. Arguably, this connectedness resulted in the programme becoming pivotal in the advisors’ careers.5
The article also addresses why TV was deemed a powerful conduit for bringing discussion about VD from the public sphere to the home. It acknowledges the transfer of expertise from radio to TV and the unique position held by the BBC in reaching schools and colleges. It looks at how teenagers were perceived as a distinct public. It also reflects on the contribution of another trailblazing series for teenagers from 1966 which foregrounded what teens like to do – talk – and, arguably, in its absence, the BBC’s programme would have been untenable. Evidence of the programme’s critical and commercial success is then explored.6
2 Twentieth Century Focus
Delivered as part of Social Studies, an educational discipline developed by James Hemming, Twentieth Century Focus (1966-1974) was a series devised to address the impact of emerging societal issues to teenagers.7 In the UK, Social Studies emerged on school curricula to enrich children’s educational experiences, prepare them for adult life and to give young people agency.8 Hemming was a member of the Television Research Committee set up to investigate the impact of mass media on the moral development of young people. With reference to educational TV programming, he urged for the normalisation of sex outside marriage and the promotion of “self-respect and concern and compassion for others” in relationships (as opposed to emphasising sexual behaviour). His experience was that young people were responsive to this pragmatism.9
Hemming’s philosophy is included in the BBC programme file as a modus operandi for the Twentieth Century Focus production unit under Gordon Croton’s leadership. Reflecting Hemming’s recommendations, in 1973 a trio of programmes entitled ‘Health Hazards’, was devised to tackle smoking, VD and drugs. Croton stated, “This is an essentially sceptical audience which does not easily accept what it interprets as homily or propaganda: the approach of the unit must, therefore, not be moralistic and prohibitive yet its purpose should be, quite unequivocally, to point up the dangers attendant on an unthinking attitude towards the subjects of the three programmes.”10 This was the first time the BBC had explicitly tackled these topics for a teenage audience – and in colour.
3 The Programme
The 20-minute programme framed the problem of sexually transmitted diseases (STDs) in teenagers by structuring the programme around a lecture by a consultant venereologist (Robert Morton) on the prevailing understanding of the aetiology of VD together with salient facts about the recognisable pathologies and prevalence of the different kinds of VD, followed by a dramatized contact tracing scenario and final discussion with students (featuring Frank Rowntree, Health Education Officer).
It includes (staged) sequences of young people aged 14-15 years old attending a health education exhibition on VD; these exhibitions were an important feature of many health education officer’s activities. As well as a break from the classroom, the exhibitions allowed browsing, talking and asking questions; the objective being to promote discussion – at the end of the programme the same group is engaged in a Q & session. The dramatized section used health service staff and two actors, a man and a woman, ‘Bob’ and ‘Veronica’,11 who enact a sexual contact tracing scenario. In the drama, ‘Bob’ goes to the sexual health clinic and tests positive for VD; a social worker tracks down the young woman, ‘Veronica’, who infected him and informs her about her health status.
4 Health Context
To summarise attitudes toward VD infections in the period after 1945, there was a real hope that STDs were “dying” diseases as they could be treated with antibiotics.12 Antibiotics reduced VD infection rates and with the contraceptive pill, the fear of the consequences of sex outside marriage had also diminished.13,14 The pill, it was claimed, led to a decline in condom use and the persistence of certain VD infections.15 In the media, there were conflicting messages on the incidence of VD, and it was asserted that VD was “near epidemic” or at “high epidemic levels in many countries”.16 However, syphilis was rare in the UK and it was only gonorrhoea that had been increasing. Also included in these infection statistics were ‘non-specific urethritis’ (in men) and ‘non-gonococcal’ (in women), better known now as chlamydia (a bacterial infection). At the time the programme was made, the causes of chlamydia were not known and symptoms in men and women were considered to be different conditions. It was understood that these infections could be spread sexually and be detrimental to fertility, although the full understanding of the causes of chlamydia came later in the mid-1970s after the programme in question had aired. This shift is relevant to understanding the programme’s obsolescence.17
The press communicated the facts given by health agencies, but also sought to tell a story. This resulted at times in unsubstantiated claims and the liberal use of the word ‘epidemic’ which heightened anxiety.18 Looking critically at whether there was an ‘epidemic’ of infections or an ‘epidemic’ in anxiety about them, VD was not a notifiable disease in the UK and there was no national surveillance programme. This caused confusion regarding the actual numbers of infections and they were thought to be underestimated.19 This anxiety resulted from the available regional and national data-omitting patients who were treated outside hospitals by their local doctor.20,21 Even though infections dipped in 1970, the data still received widespread press attention, highlighting an apparent resurgence of VD.22 Mirroring newspapers’ approach, public health leaflets suggested that casual sex led to VD, caused “ill-health”, could be “dangerous” and resulted in “suffering and sterility”.23 School age children were considered to be most at-risk, and in response, the tabloid newspaper press lobbied for government to supply schools with films and other warning aids.24 Paradoxically, an influential study on sexual behaviour in teenagers in 1965, reprised in 1973, found that young people were not as sexually active as everyone had believed, although they were ignorant about sex and, consequently, VD.25
5 Television Power
By the early 1970s, TV had become a feature of family life as television ownership grew with its role in the family being critiqued, together with its potential “power”.26 Evidence indicated that teenagers were the least interested in TV demographically; this was attributed to the lack of ‘teen-friendly’ programming.27 However, although most young people gained (mis-)information about sex from their school friends, support grew for TV to provide sex education.28 Young people claimed they wanted their parents to give them information about STDs, but parents, when surveyed, wanted someone else to take this on. After their parents, young people turned to their teachers, who felt that they were underequipped to deliver good quality sex education, due to diffidence or inadequate training.29Marjorie Proops, columnist and ‘Agony Aunt’ to the British tabloid newspaper The Daily Mirror, writing in 1971, described parents as “bewildered” and “confused” about sex education and that both teachers and parents believing the task of informing young people about sex to be “unpleasant” and “very difficult”.30
The emerging use of TV as a medium for disseminating sexual health messages had advantages over its cinematic predecessor. From the earliest days of cinema in Europe and the US, films had been used to both inform and entertain using the moral and emotional dilemmas caused by VD.31 However, there was very little evidence that existing sex education TV programming had successfully imparted the risks of VD, although it provided reassurance to young people about emotional attitudes and misunderstandings about sex.32 In 1970, Sir George Godber, Chief Medical Officer for England, urged for the financing of a British film along the lines of the American production Half a Million Teenagers about VD or, failing that, the commercial distribution of already existing titles.33 Creating new material suitable for a modern sensibility using colour, sound and higher production aesthetics was challenging: media production required logistical, financial and artistic wherewithal. The world of TV demanded media expertise and experts who could operate in a collaborative production framework. Unfortunately, health practitioners were “almost totally ignorant of the artistic and technical complexity of television”.34 Health experts were considered to be unqualified for this role as, “it takes a Zeffirelli to hold attention and story line […]; health educators would do better to stick to ten-minute single concept films.”35 Therefore, potentially, TV could be granted a role, or the power, to broker discussion about sex, if the educators could work collaboratively with producers.
6 “Television Joins Radio”36
Gordon Croton, like many television producers, began his career in radio.37 His first radio broadcast credit was for the BBC Home Service in March 1958 in ‘Landladies I have known’. In 1959, he produced a programme about young couples setting up and furnishing a home together. Then in 1963-1964 for BBC Network Three, he produced a series of educational programmes for their Study Session strand. Croton’s first foray into television was a 1965 series for BBC Schools, Going to Work. Then in 1967, he produced a programme about pursuing a career in nursing, a topic he returned to in 1971 for an educational series Practical Techniques for Nurses in Training; 10 programmes for student nurses with booklets. Here Croton encountered consultant nurse, educator and writer of nursing textbooks, Winifred Hector, who would help him develop and write the programme notes for ‘Health Hazards’. Hector gave Croton access to her clinical know-how and an insight into how women experienced healthcare services.38
By the beginning of the 1970s, BBC education broadcasting had settled into a framework of production with two advisory councils supported by a professional team of educational officers, administrators and researchers.39 It became the norm for producers to collaborate with outside agencies for mutual benefit and production became “a more intimate procedure in which research, resources, knowledge, promotion and publicity were shared”.40 For ‘Health Hazards - VD’, these were four experts from public health, venereology and educational disciplines; two in front and two behind the camera: Dr Robert S. Morton, Consultant Venereologist, Royal Infirmary, Sheffield; Frank Rowntree, Health Education Officer, Sheffield; Dr Arthur James Dalzell-Ward, Health Education Council, and Dorothy Dallas, Lecturer in Education, Kings College, London.
The School Broadcasting Council (SBC) which sponsored BBC Schools broadcasts emphasised that the approval process for programme development and production could entail up to fifteen stages.41 One example of how the administrative process worked is suggested in a memo in the BBC production file from David Grattan, Controller, Educational Broadcasting, to Croton when he agrees that a potentially controversial in-context reference to the contraceptive pill would be acceptable.42 This is illustrative of the system of referrals upwards of difficult decisions, minimising production delays.43 The next opportunity for the SBC to cast judgement on the programme would be at a screening upon completion. It was no doubt helpful for Croton that Grattan had had a similar career trajectory; they would have encountered each other in their radio days.
7 The Health Education-Television ‘Enthusiasts’
Winifred Hector’s career in TV began after she approached the production office of the BBC radio programme Woman’s Hour for technical advice after recording the lived-experience of a patient with a skin condition; the recording was intended to be used in teaching students about the patient experience.44 The interviewee, however, disclosed information about an abortion she’d had (which was illegal in the UK at the time). An engineer assisted her in redacting the abortion reference and improving the audio quality of the recording.45 Perhaps emboldened by this encounter, Hector pitched the idea of a broadcast series for trainee nurses, this being her area of expertise, wherein she encountered Gordon Croton: “There now appeared my second producer, a lean and sardonic figure, intelligent and very articulate, and after a number of encounters we settled down to a working relationship that I personally found very satisfying.”46 The proposed nursing series went on to become mutually beneficial, Hector noting: “…sales of this consultant’s books rose noticeably, and […] the producer seems to have gained in prestige in the BBC.”47 Croton was ambitious and with this success behind him, he lobbied to make future programmes in colour which would further the impact of his productions.
The BBC Education Officer, Yorkshire Division, recommended both Morton and Rowntree to Croton who were connected not only geographically, but also professionally. Morton had written an influential book about VD in which he mentioned Rowntree’s work.48 An important component in the ‘Health Hazards – VD’ programme is the lecture by Morton on the history of STDs; this was pre-recorded with additional footage added later. These historical sequences elicited sustained interest by teenagers; evaluation in the form of confidential ‘white’ reports (internal documents akin to governmental white papers) was based on feedback from regionally and socio-economically diverse schools. Members of the public could also access the broadcasted programmes, for example, an “elderly schoolfellow” wrote to the BBC with a question about where VD came from, what came first, “the chicken or the egg?”, i.e., sex or venereal disease? Croton’s production secretary, Fenella Sturt, wrote back to the enquirer with a recommendation to read Morton’s book and concluded that VD was zoonotic in origin.49 This gives just one example of the wider inter-generational interest in VD as a subject.
Rowntree, an ‘enthusiast’ of public health education, was the Health Education Officer for Sheffield, England from 1959-1974.50 He used multi-media visual aids in health education, pioneering several health education exhibitions in Sheffield (including the one on VD shown in the programme).51 Health exhibitions were considered critical to reaching diverse communities, although few were about VD.52 Discussion was deemed to be critical in health education, a view echoed by Rowntree; “questions of sex and its associate diseases branch naturally out of matters of personal hygiene, courses of lectures, demonstration, film strips and discussion groups at schools, youth clubs and welfare centres are aimed at giving the young factual knowledge, with a sense of citizenship and a consciousness of the need for individual responsibility.” Rowntree believed that television (and film) could be problematic in communicating information about sex and the exact nature of risk. His own media analysis involved evaluating how much information was retained by very young children after watching two health cartoons which was, disappointingly, weak when tested.53
Arthur James Dalzell-Ward, the Chief Medical Officer for the Health Education Council, advised the BBC production on the role of the sexual contact tracer, another component to the programme and an important weapon in sexual disease control – combining the roles of medical officer, social worker and detective. He was active in the formation of the British Federation Against the Venereal Diseases in 1951 and appreciated the value of film in public health education.54 Alongside other health practitioners, he felt that the sector’s film needs were not being met:
“The drawback to conventional documentary film is that they are expensive and too long. Moreover, the days when a “film show” without discussion was considered to be satisfactory operation have gone for ever. The Central Council for Health Education’s staff have always believed that a new kind of film was needed that could be used entirely as a device for producing discussion like a talkie-strip, but would be more emotive than still pictures.”55
Considering the superiority of television, Dalzell-Ward was clear: “At one time the cinema film carried its own authority, but with the advent of television this authority is no longer enjoyed as of a right.”56
Dorothy Dallas, writer and lecturer, was a vocal supporter of audio-visual health education. Her support was sought in promoting the programme to teachers and her evaluation documentation appears in the BBC archives for the programme framed by some nervousness about her forthrightness: attending a BBC public relations and sales screening for the ‘Health Hazards’ episode on smoking with a personal tape recorder, she breached etiquette by dictating her notes aloud, allowing her views to be ‘broadcast’ to everyone there. In her role as organiser of the South London Teachers Working Party, she organised the viewing, discussion and the development of additional (unofficial) educational resources to go alongside material on sexual health. Whilst the BBC was in production with ‘Health Hazards’, Granada Television broadcasted a series for teenagers, Facts are These, which included an episode on VD, ‘Love Now, Pay Later’.57 Dallas considered this production, which was in black and white, not appropriate for school use as it was “too verbal and too authoritarian” – and the clinic scenes were “too clinical”, but the symptoms were the best she had seen, being both “aesthetic and clear”. Additionally, she preferred colour films, deemed more impactful and more emotive.58 Her views about the ‘Health Hazards – VD’ programme were positive, liking the way the facts were depicted, remarking on the over-reliance of talking-heads, but pleased with Morton’s “performance”, which came across as an “identifiable friendly doctor” with an “excellent” depiction of the social worker and contact tracer and “not a sign of the VD gestapo, just nice ordinary friendly people who wish you well”.59 Although there is no archival evidence of Dallas’ feminist credentials, her robust (and potentially offensive to the contemporary reader) language (“VD gestapo”), speaks to the way that sexual contact tracing was perceived as being intrusive and morally judgmental, especially to women. Overall, she recommended the programme for its use of “non-sickening” symptoms and its tone of reassurance.
Dallas developed strident views about sex education, an area which had emerged as controversial, not only in the UK, but also across what was becoming an increasingly globalised world.60 In 1971, in the UK, there was a media furore over a provocative sex education film for schools, Growing Up (1971), created by Dr Martin Cole, that showed footage of male and female masturbation (the latter proving the most controversial) and sexual intercourse.61 A debate about the programme was aired in an episode of the BBC Man Alive series, ‘Sex and Common Sense’ in June 1971.62 The film was so divisive, it estranged both parents and educators in the debate over access to sex education in schools.63 After the broadcast, the series editor, Desmond Wilcox, replied to viewers’ letters in The Radio Times; he likened the furore to an example of intergenerational conflict, noting that, “It’s my own – older – generation – which seems to get noisy, didactic and abusive about sex”.64 The conflict illustrated how those who opposed sex education seized on controversies, thwarting openness. Dallas wrote about this debate, identifying it as contributing to her antipathy to the airtime given to opposers of sex education on the one hand and her despair at the quality of the available material on the other.65 In schools, she had observed that the quantity of material was not the issue; it was duplicated in Biology, Religious Education or Social Studies lessons.66 The issue was that in the absence of a co-ordinated national policy, sex education in schools had led to repetition and complaints from teenagers that they had “done VD”.67 Ultimately, she hoped that television would be a conduit for well-articulated current information about sex and that this would lead to intergenerational understanding.
Understanding, critiqued by Dallas and produced by Granada in 1966 for teenagers, was perhaps the most well-known TV series in educational circles covering sex education.68 The ‘Health Hazards – VD’ programme was unthinkable without considering Understanding as its direct antecedent.69Understanding was a series of discussion programmes about family life, sex, sexual behaviour and related social ‘problems’ such as illegitimacy and VD. It was designed to stimulate responsible discussion between pupils and teachers mindful of the effect of television to generate “a wide and indiscriminate audience”.70 It was evaluated by inviting three classes of fifteen-year olds described as “average to below average intelligence” to watch the programmes and then give feedback via questionnaires. Teenage viewers’ actual understanding of the subject was weighted; both boys and girls found the VD programmes to be the most interesting.71 The evaluation for the series was published and widely distributed with it becoming a standard ‘text’ for good practice in engaging teenagers on these issues.72
The producer, Elaine Grand, had made other Granada programmes on difficult topics.73 As part of the research process for Understanding, she had consulted people working in health education. After making a pilot programme for the series, her conclusion was that adults do not know the questions children want to be asked. After it had aired, evaluation revealed that unlike other schools programming, no telephone calls or letters of complaint or praise were received from the public.74 Conversely, correspondence from schools themselves was much greater than usual – more than 100 schools provided feedback with the surprising statistic that 88% of these regularly used television in the classroom. Teachers also noted how untypical free discussion on such ‘difficult’ subjects - or anything at all - was in many schools.75 What was progressive, but accidental, was that the programme was watched by mixed gender groups (historically, audiences for topics relating to sex education had been divided by gender in the United Kingdom).76 On this occasion, feedback indicated that the shared experience of hearing the reactions of classmates of the opposite sex was considered helpful by the mixed gender audiences.
The ‘Health Hazards – VD’ programme followed the successful model pioneered by Understanding: the target audience’s reaction and its pedagogical value could be foreseen. The BBC also had the further advantage of making their programme in colour. Feedback about their VD episode was overwhelmingly positive: “best seen on VD style and treatment”, the young people “liked historical sequences and ‘clarity and authority’ of ‘experts’”, the “initial tone” and “non-moralising” approach.77 The definition of ‘casual sex’ was disliked (preferring ‘casual sexual relationships’ instead), whereas the conflict of the relative commonness of VD (destigmatising it) versus the promise of anonymity when seeking treatment was well-received. Further questions arose over information about screening clinics and whether to confide in the family doctor (no details were provided alongside the programme). Both Morton and Rowntree approved of the finished programme, with Morton complimenting Croton:
“I think you have made a splendid job of it. It strikes me that the programme is not only suitable for teenagers but I think suitable for an adult audience also. In fact, it seems to me that it would be best suited to what might be called ‘family viewing’, i.e. Young people and their parents to share the common experience of seeing films like this in the hope that this would make for freer discussion of such medico-social problems.”78
Its success was tempered by how sex education later became a contested field and this “didacticism”, disliked by Dallas, would prove problematic in the future.79 A glimpse of what this looked like is in Croton and Morton’s correspondence:
“I was told yesterday (though with little detail) that Lord Shawcross and his group “The Responsible Society” will be producing a programme […] and that they are likely to be examining the role and responsibility of television. Apparently they object strongly to any form of sex education on television, and are at present attempting to convince the BBC that they should be allowed to use extracts from the VD film to prove how harmful and potentially sinister such programmes can be for young people. […] I am sure you will be interested to see what an ultra-puritan group make of our carefully conceived programme.”80
Editorial policies which allowed political balance meant that voices opposing open discourse about sex in the 1970s and 1980s in the UK gained a platform for their views. The “harmful” material referred to here, the brief shot of diseased genitalia, taken out of context, was criticised as causing alarm and disrupting the aim of the programme.
Evaluation proved that TV could successfully deliver well-articulated messages about STDs which met with approval by educators, parents and teenage audiences. However, the development of factual TV programming has roots in journalism before the notion of public service. Stories concerning VD that were circulating widely in the press at the time elicited keen interest from the public and journalists alike, and correspondingly, according to Peter Goodchild, editor of the TV series Horizon, successful factual programming had to have mass appeal. In the planning stages, TV commissioning is based upon viewing statistics which influence the production bias (entertainment versus education). Illustrative sizes of mass viewing experiences in the 1970s were 20-25 million viewers for sport and Miss World versus 5 million viewers for documentaries; entertainment clearly eclipsing factual programming, and educational programming a small subset of the latter. Consequently, the relative critical success of the ‘Health Hazards – VD’ programme may have been unwelcome in some production circles, as it created an expectation that TV would respond to future health crises with salutary health programming. Goodchild acknowledged the success of the programme on the one hand, downplaying the likelihood of further programming on the other, citing potential audience fatigue and a sense of having “done VD” – at least for the time-being.81
What began as an investigation into the provenance of a 1973 film on VD led to the discovery of a network of medical, health education and TV experts converging on the production of this programme. The reputation and mutual respect of the participants and creators attests to the importance of the programme in the early-1970s, as well as to the social, political and pedagogical considerations that were incorporated in its production. The findings from books, journals and archives from Wellcome Collection, outline some of the reasons that the ‘Health Hazards - VD’ programme was considered a critical success. Firstly, it involved an unusually united grouping of experts who knew each other professionally. Consultation with a variety of advisors and health education ‘enthusiasts’ followed a well-tested approach to educational TV integrating prevailing pedagogical thinking on how to reach teenagers on difficult subjects. These participants were not neutral and cared passionately about the benefits of sex education – their careers had been predicated on it – and TV. Secondly, in line with contemporary pedagogical thought around engaging teenagers as active agents, it had been observed that discussion was a powerful tool in exercising personal responsibility as “it can exploit the well known tendency for adolescents to argue and to discuss” thereby contributing to an effective production approach.82 Granada Television had led the way, informing later productions on both public and commercial television. TV was deemed to have a role in provoking the right kind of discussion, although thereafter, VD education in the 1970s, at least on TV, shifts and was delivered in less obvious ways such as drama (for example, in the form of “trigger” playlets).83
A factor in the VD programme’s subsequent obscurity arose from the overwhelming consensus behind and in-front of the camera: all the literature on sex education focusses on the controversies (as Growing Up and Understanding had attested). Croton spoke of Shawcross’ desire to use the programme as part of the counter-argument around the perceived harm of sex education; the BBC refused access to extracts from the production, the inclusion of which would have elicited comment and extended the debate. Ultimately and rather mundanely, actors’ contracts limited further transmissions and shortly thereafter, the programme became obsolete when research into the true aetiology of chlamydia emerged.