Tuberculosis cases in England rose by nearly 14% in 2024, and drug-resistant strains have reached their highest level since records began. As the UK Health Security Agency develops its new TB National Action Plan for 2026 to 2031, the focus is rightly on diagnosis, treatment and prevention. Yet the historical record suggests that one aspect of tuberculosis’s legacy remains under-recognised in policy discussions: the long-term psychological and developmental impact of prolonged hospitalisation in childhood. My father, Harry Drabble (1934–2022), provided one of the few recorded survivor testimonies of childhood bovine tuberculosis in pre-antibiotic Britain. He knew that tuberculosis was increasing worldwide and becoming more drug resistant, and he was particularly worried that mistakes in the way children were treated would be repeated. His testimony shows why that concern deserves attention. The analysis is grounded in longitudinal survivor testimony and historically contextualised research on paediatric tuberculosis, institutional care, and the life-course impact of childhood illness. Integrating historical patient testimony into policy discussions can help ensure that long-term psychosocial outcomes are not overlooked in future TB strategy.
In July 1937, two-and-a-half-year-old Harry was pulled from his mother’s arms at the Royal Hospital, Sheffield. He had been diagnosed with osteoarticular bovine tuberculosis, a chronic infection of the bones and joints contracted through unpasteurised milk. He would spend much of the next five years in the King Edward VII Memorial Hospital for Crippled Children in the Rivelin Valley, encased in plaster from armpit to ankle, and largely cut off from his family.
Harry’s was not an unusual case. In 1934, the Sheffield Independent reported more than 4,000 fresh cases of bovine tuberculosis annually in England and Wales, and approximately 2,000 deaths. The disease primarily affected children who drank contaminated milk. Once infected, the bacterium destroyed soft, growing bone. Treatment involved immobilisation, splinting, traction, and body casts, often lasting years. Before streptomycin became available in the late 1940s, there was no curative drug.
The institutional regime governing Harry’s care reflected prevailing medical orthodoxy. Children were signed over by their parents for the duration of treatment. Visiting was restricted to one close adult relative for one hour, once a month, on a Sunday, and was frequently cancelled without explanation. Toys, books, and familiar objects were confiscated as infection risks. Initially, children were not allowed to feed themselves or to speak to one another. Nurses sat out of sight behind the heads of particularly ill children so as not to invite demands for attention. These arrangements followed from institutional assumptions: that quiet children were content, that parental visits caused disturbance, and that clinical detachment was sufficient.
The psychiatric social worker James Robertson, working alongside John Bowlby at the Tavistock Clinic from 1948, later identified the stages of distress in separated children: protest, despair, and finally detachment. Children who appeared to have ‘settled in’ were in fact emotionally overwhelmed. Harry’s testimony closely matches these findings. He described the ‘white-hot fury’ he felt when first taken from his mother, followed by an indifference he could neither understand nor control. On his first discharge, aged nearly five, he found his family home unrecognisable. He struggled to return affection and told his mother on VE Day, aged 12, that he wanted to go back to the hospital.
The psychological damage extended throughout his life. Harry detested white rooms, could not tolerate anyone placing anything in his mouth, and found intimacy and trust profoundly difficult. His contemporary at the same hospital, Derek Godbehere, described an identical pattern: ‘Hospital changed my character. I couldn’t show my feelings. Some people saw me as cold. It’s not that I don’t feel. I feel it inside, but I can’t show it.’
Nursing staff were also constrained and psychologically affected by the institutional system. The teenage probationers who delivered most of the hands-on care were forbidden from comforting or playing with their patients. As Robertson observed, the psychological defences they developed were so powerful that the kindest of staff could be wholly unaware of the emotional harm they were colluding in. One nurse, interviewed about her experience, recalled the distress of a toddler left sobbing in his cot and her helplessness when a senior colleague strapped the child into a harness. She described it as one of the worst things she witnessed.
The Platt Report of 1959 recommended that parents should have greater access to hospital wards, but institutional resistance meant the pace of change was glacial.
Since the mid-twentieth century, paediatric healthcare has undergone profound reform. Family-centred care, unrestricted parental visiting, safeguarding frameworks, child psychology, and trauma-informed practice are now widely embedded in UK clinical standards. Prolonged institutional separation of young children, once routine in tuberculosis hospitals, would no longer be considered ethically acceptable in contemporary paediatric care.
However, the historical record remains policy-relevant. Children across the world still experience prolonged hospitalisation, isolation for infection control, and complex long-term treatment, including for tuberculosis. The lesson is therefore not that contemporary care mirrors the 1930s, but that policy must remain alert to the life-course psychological impact of prolonged childhood medical environments, even as clinical, ethical, and family-centred practices have substantially improved.
Three lessons emerge from Harry’s testimony that are directly relevant to the forthcoming TB Action Plan and to paediatric long-term care policy more broadly.
First, the effects of early institutional separation are not limited to a difficult childhood. They shape adult relationships, emotional regulation, and self-perception across the entire life course. Trauma-informed healthcare frameworks would be strengthened by recognising the historical evidence of what happens when children’s emotional needs are systematically overlooked. Second, the assumption that clinical objectivity alone constituted good care proved damaging both for children and for the staff who delivered it. Policies that exclude families from care decisions risk reproducing patterns from the past whose consequences are well documented. Third, the long-term physical and psychological costs of prolonged childhood hospitalisation under a clinical objectivity regime have been substantially underestimated. Their effects shaped Harry’s life for nearly nine decades.
Despite his traumatic start in life, Harry later taught himself to read using a Bible on the ward, was the only man with a physical disability to earn a building diploma, and became an accountant. As policymakers draft the next national plan for a disease that is once again on the rise, and as drug resistance makes treatment longer and more complex, his testimony is a reminder that treating the infection is not the same as caring for the child. Harry feared that without the evidence of survivors like him, the mistakes of his era would be repeated. Shortly before his death in 2022, he said: ‘Maybe my story will help someone.’ It should.
