I’m pleased to feature the first of two very interesting guest posts by Dr Jill Stewart, Senior Lecturer in Environmental Health and Housing at Middlesex University. They cover the important, sometimes neglected, work of our earliest environmental health practitioners. You can follow Jill on Twitter @Jill_L_Stewart and see more of her work on her personal website, Housing, Health, Creativity.
The idea of a job dedicated to dealing with industrial smells, boiling bones, accumulations of filth, offensive trades, drains, effluvia from public graves, abattoirs and sewage contaminated basements may not be everyone’s ideal career path. Thomas Fresh apparently thought otherwise and practically invented this new job for himself in the progressive borough of Liverpool (1).
The aptly named Fresh effectively became the first Inspector of Nuisance statutorily appointed by Public Health Act 1848, setting the path for a professional trail of Sanitary Inspectors, Public Health Inspectors and latterly Environmental Health Practitioners to intervene into environmental factors affecting the health of the nation.
Many had been pushing for the state to intervene in public health for some time although there was also much opposition. Those proposing change included Edwin Chadwick who first linked environmental conditions and health in The Sanitary Conditions of the Labouring Population in 1842, which he researched and publicised at his own expense. (2)
Chadwick and many other prominent figures continued to wrongly attribute disease causation to miasma, or ‘foul air’, yet many of the interventions instigated were to nevertheless show improvements in health. Chadwick became the first president of the Association of Sanitary Inspectors in 1884. Sanitary Inspectors – in some places still named Inspector of Nuisance – were seen as the ‘practical doers’ who intervened in poor housing (amongst other things), working closely with the higher status – and far higher paid – Medical Officers of Health.
Surprisingly little has been written about the major role of the Inspectors charged with dealing with the nation’s poorest housing stock. However the stage was set for new legislative provision to be developed and enacted.
The Common Lodging Houses Act 1851 sought to respond to the complex social and health issues found in such shared accommodation. It required that such premises met certain registration and hygiene standards as shown in the extract from an Inspector of Nuisance’s 1899 notebook below, together with the recommended sleeping arrangements.
A range of other legislation followed, providing new powers for local authorities to intervene into certain housing conditions but with limited remit. These included the Labouring Classes Lodging Houses Act 1851 and the Artisans and Labourers Dwellings Improvement Acts (Cross Acts) of 1875 and 1879. The latter provided powers to intervene in unfit housing, and clear (with compulsory purchase powers) and redevelop land for improvement for the working classes. The Public Health Act of 1875 enabled proactive local authorities to adopt bye-laws to control building standards and the situation remained erratic across the country.
Local authorities were reluctant to do much due to the substantial costs involved. The Housing of the Working Classes Act 1885 required proper sanitary conditions with an implied condition of ‘fitness’ for habitation – a provision to broadly remain in place until 2004. The Housing of the Working Classes Act 1890 consolidated various acts, with provisions dealing with unhealthy areas and improvement schemes, unfit housing and powers to provide lodging houses, but there was no funding. (3)
An 1896 edition of the Sanitary Inspectors Journal said: (4)
To pave streets, to construct sewers and to drain houses, however necessary these works may be, are among the least important of the duties which devolve upon the Sanitary Authority. But to improve the social condition of the poorer classes, to check the spread of disease and the prolong the term of human life, are works of high and ennobling character and are duties which devolve upon the Local Authority…It is often found that when an intelligent artisan has once become acquainted with the advantages of any of the laws of civilisation, he is not slow to avail himself of their aid, and habits of cleanliness [once] formed, his sensibilities become improved to such an extent that he will not live in a room which is unhealthy, or in a house that has bad drains.
This edition also reported on cases of houses unfit for habitation. In one case, the owner was summoned for allowing a nuisance caused by damp sites, defective gutterings, gullies and water closets. The council wanted the landlords to remove the wet clay floors and cover with concrete, leaving ventilation space under the joists and asked for the garden to be lowered and properly paved, estimating a cost of £84. Evidence presented included detail of a neighbour’s death from diphtheria and stagnant water under the floors. The Bench ordered the owner to execute the works within a month and allowed £3 3s costs.
One of London’s most notorious slums – the Old Nichol – is brought to life in Sarah Wise’s excellent book The Blackest Streets, the title based on Booth’s work around the chronic poverty he had found in that area (5). Thousands of residents lived in poor conditions in around thirty streets. The mortality rate was around twice as high as the rest of Bethnal Green.
The book presents all the challenges faced by the inspectors, with resonance today: how to assess and respond to areas of slum housing; difficulties in identifying owners; rents payable in relation to condition; appropriate level of compensation payable to owners in lieu of loss of property; social isolation; effects on behaviour. In the clearance process, not just homes but livelihoods and communities were displaced and lost. It is reported that of the 5719 residents moved out of this cleared area, only eleven moved back because the rents in the new arts and crafts-inspired buildings were too expensive; an early example of what we would now call ‘gentrification’.
The resulting new Boundary Estate was to become the London County Council’s first ever council housing, funded locally, and completed in 1900.
With a link of environment and health now firmly established, housing interventions began to take greater prominence as across the county – albeit erratically – poor housing was linked to higher morbidity and mortality with overcrowding, common lodging houses, poor drainage, narrow streets, people living in cellars, inadequate water supplies. More progressive boroughs developed bye-laws to address the worst housing, with positive health outcomes emerging where conditions were tackled. Housing was to take prominence in health debates with Sanitary Inspectors frequently to the fore (6).
The Housing and Town Planning Act 1909 helped local authorities control development and introduced some development controls, such as prohibiting back to back houses. In 1909, the Sanitary Journal reported that Leeds persisted in these and concern was expressed that such property was unhealthy. Concern was expressed that Sanitary Inspectors were trying to do all they could but the magistrates did not always back them up. There was still the bureaucracy of the Medical Officer of Health to make representation to the local authority regarding each house unfit for habitation. Still less than one per cent of housing stock had been provided by municipal and philanthropic activity.
By 1910 the Sanitary Inspectors were frustrated at lack of investment into housing and the problems this led to in their work: (7)
Many other towns have tackled bad houses, and yet the sum total of what has been done only touches the fringe of the problem, the solving of which under the Housing of the Working Classes Acts is a financial impossibility. Five million people at the very least are living in houses that require improvement.
In the lead up to the First World War, though still sporadic in practices across the country, the Sanitary Inspectors Association was really becoming a national force to be reckoned with as local government departments consolidated their functions. They argued that ‘everyone person who is interested in the housing problem knows that healthy homes cannot be provided at rents to suit the means of the poor on land that costs more than £300 per acre’. They already felt it highly improbable that the private market would provide affordable housing for the poorer classes and argued that the state should provide funding for housing.
In 1910 the Sanitary Inspectors were very clear on the importance of healthy housing: (7)
The removal of existing evils will be slow. It is said that the people cannot be improved by legislation, but legislation certainly indicates the trend of public opinion, and on the subject of housing, public opinion is steadily growing and in time will be sufficiently strong to sweep away hovels that are called houses, and will provide the people houses fit to live in, and for the children places other than insanitary back streets to play in. Towards that object let me urge all present, whether members of officials of Sanitary Authorities, to do all that lies in their power, for nothing is of greater importance than that our children, the greatest asset of the nation, should grow up in a healthy environment, with healthy bodies and minds, so that they will be able to solve for themselves higher and more important problems than the Housing of the People.
In next week’s post we again focus on the little spoken-of housing powers of the inspector’s work that tackled chronic slum housing conditions and area clearance between the wars. By then, Sanitary Inspectors and others had informed the decision of the state to fund council house building to replace slums and a new era of ‘municipal dreams’ would emerge.
Dr Jill Stewart (firstname.lastname@example.org)
(1) Parkinson, N. in Stewart, J. (ed), Pioneers in Public Health: lessons from history (Routledge, 2017)
(2) Edwin Chadwick, The Sanitary Conditions of the Labouring Population (1842)
(3) Parliament’s ‘Improving Towns’ webpage provides a useful legislative timeline.
(4) Sanitary Inspectors Journal (1896)
(5) Wise, S. The Blackest Streets: the life and death of a Victorian slum (Vintage Books, 2009)
(6) Hatchett, W., et al. The Stuff of Life: Public Health in Edwardian Britain (CIEH, 2012)
(7) The Sanitary Journal (1910)