I’m very pleased today to feature the second of two guest posts by Dr Jill Stewart, Senior Lecturer in Environmental Health and Housing at Middlesex University, covering the important and 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

As the Great War drew to its end, the Sanitary Inspectors put forth their values and vision for housing for a new era of Homes fit for Heroes to live in: (1)

Proper housing is necessary on account to our climate, which makes it requisite, or at all events, desirable, that we should have shelter and protection from the elements. Also, in accordance with our modern ideas of civilisation, having progressed beyond that age of cave-dwellers and gipsy life…it is also very necessary for the proper upbringing of our children, so that they may develop into a healthy and virile race, sound in body and mind, and worthy of our great Empire, which, in due course, it will be their duty to maintain.

Before the War, as we saw in last week’s post, some more progressive councils has begun the process of slum clearance and area redevelopment, but the situation was erratic across the country. The war-time Munitions Estates, based on garden city ideals, had provided good housing for munitions workers in locations including Well Hall, serving the Woolwich Arsenal. (2)

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Homes on Dickson Road in the Well Hall Estate

It is here that Dr Christopher Addison, then Minister of Munitions, later President of the Local Government Board and then the first Minister of Health, really comes to our attention for his work in state subsidised housing estates. As doctor turned learned politician, Addison’s understanding of poverty and health provided comprehensive impetus behind the Housing and Planning Act 1919 (Addison Act), recognising the need for council housing that was of decent quality and set in good environments in accordance with the recommendations of the 1918 Tudor Walters report.

However, there remained the perpetual problem of the thousands who continued to live in slums, despite ongoing interventions by the Sanitary Inspectors and Medical Officers of Health. This massive challenge resulted from sheer numbers, legal processes involved, and where to house those displaced by clearance.

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Many streets continue to bear Dr Christopher Addison’s name, the housing here shows Arts and Crafts influence. Photo Jill Stewart

Whilst still President of the Local Government Board, Addison received deputations from the London County Council and the Greater London Local Authorities supported by the Sanitary Inspectors and relating to government financial assistance for large scale slum clearance and local housing development. The deputation asked for two things: that the deficiency grant be similar for those displaced but remaining in the slum cleared area as those re-housed in land not previously built on; and that processes to acquire slums from landlords prior to clearance should be both cheaper and quicker. In turn, Addison urged those present to deal with sanitary areas and build new homes without delay in advance of the forthcoming new legislation.

Betrayal SNHowever with a lack of progress related to inadequate resource for both slum clearance and new houses fit for human habitation, the situation was bound to come to a head and, following the Government spending cuts of the 1922 Geddes Axe, Addison resigned. He published The Betrayal of the Slums in 1922, displaying fascinating insight and perception of what it meant to live in slums, the effect on health and costs to society. (3)

In Betrayal, Addison observed that in 1922 there were nearly a million ‘homes’ consisting of a maximum of two rooms, and that there was no nowhere else available for the tenants to relocate to. He referred to such places as entirely hindering people’s lives, development and opportunities, with no privacy, no opportunity for quiet or rest, no space for the mind and a ‘poison’ for the body. He clearly states the fact that this is entirely unacceptable for tenants and has wider cost to the rest of society: (4)

It is not the people’s fault that their life is spend in unsavoury tenements wherein they and, often enough, two or three other families have to share the same tap in the yard or on the next landing, as well as a dirty closet which it is nobody’s business in particular to keep clear. It is no fault of theirs that the mother of the family has only an ordinary fire grate in which to cook the meals and that the same room has to serve as a wash house, living room and bedrooms. It is not their fault that there is no possibility morning, noon or night for any member of the family to have any manner of privacy whatever; that the infant and the little child have to sleep in the room which other have to frequent when they come in for supper and during the evening; that is it not possible for fresh air to get through the tenement because if opens either on to a stuffy landing or is backed by another house; that boys and girls have to sleep in the same room together; that even at the time of birth, or in the hour of death, the same unyielding conditions, save for the kindliness of neighbours, similarly circumstances govern the whole conduct of their family life.

Following his resignation, Addison continued to campaign for better housing for the working classes and featured regularly in the early post-war editions of The Sanitary Inspector, praising their work and contribution to the housing process: (5)

The public are apt to forget the valuable work accomplished by the Sanitary Inspectors throughout the country, the steady maintenance of general conditions of effective sanitation is due to their devotion and toil under the guidance of the local Medical Officers of Health…The Sanitary Inspector is a hard-working and little praised official, who carries out much of the unpleasant work in keeping up the general level of the health services.

The Sanitary Journal discussed what the Inspectors found in the nation’s housing stock: houses that were originally built to cheap, low standards with bad materials and lack of planning and forethought. This was seen to aggravate deplorable conditions; overcrowding; rats, mice and vermin and reports on the substantial health effects. Unhealthy areas of slums, with underground rooms and back to backs regularly feature, referred to as an “evil trinity – dampness, darkness and dilapidation”. Tenants were seen as victims of their circumstance; and some landlords criticised for failing to take responsibility for repair (6).

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Sanitary Inspectors’ 35th Annual Conference, Buxton 1922. Reproduced by kind permission of the Chartered Institute of Environmental Health

Between the wars, with a shortage of both rural and urban housing, overcrowding was particularly problematic. In a 1922 Sanitary Journal, a Mr JG Banks, Chief Sanitary Inspector at East Ham, said that overcrowding was ‘a national disaster for it must result in increased disease and mortality, immorality, drunkenness and vice being also fostered and fed in the overcrowded homes…’ (7).

Already overcrowded, many households were also forced to take in lodgers to make ends meet, leading to disease and premature mortality and, it was said, immorality, drunkenness and vice. By 1926 The Sanitary Journal reported a case of incest that the Judge directly attributed to the deplorable conditions the family lived in, and more widely the numerous common lodging houses in the street. Though the prisoner was found guilty, he was granted mercy; the Judge said that it was no one’s fault individually, but the fault of the country for allowing such housing conditions to exist. (8)

There was no let-up on poor housing and still little hope for those who had endured slum living sometimes across decades. There were numerous health risks relating to poor housing, and multiple physical and mental health effects as well as heightened risk of infectious disease such as tuberculosis and high child mortality.

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A mother and three children in a slum dwelling, c1920, from A and LG Delbert Evans, The Romance of the British Voluntary Hospital Movement (1930) (c) Wellcome Library and made available through a Creative Commons licence

Drainage remained paramount to the Sanitary Inspector’s role, affecting both hygiene standards, then a public health priority, but also the need to control rats, an ongoing problem. Much advice was given, such as in the lengthily-headed 1926 publication ‘Drainage and Sanitation: A practical exposition of the conditions vital to healthy buildings, their surroundings and construction, their ventilation, heating, lighting, water and waste services: for the use of architects, surveyors, engineers, health officers, sanitary inspectors, and for candidates preparing for the examinations of the various professional institutions’ as the diagram below shows.

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EH Blake, Drainage and Sanitation (BT Batsford Ltd, 1926). Image courtesy of the Museum of Domestic Design and Architecture, Middlesex University

The problem of rat infestation was further addressed in Stewart Swift’s work Housing Administration of 1938 (9)

Rats, mice and vermin not infrequently infest old and structurally unsound houses. In some cases they are present to such an extent as to render the house unfit for human habitation, and on every occasion they may be a contributory factor thereto. The sanitary inspector should pay particular attention to these pests, examining the house for their presence besides making inquiries from the tenant. Not every householder likes to admit the presence of vermin, and walls, back of pictures, bedding, etc., should be carefully scrutinised wherever necessary for the presence of vermin. The presence of rats frequently indicate defective drains or the presence of accumulations of matter and filth, which should be dealt with under the Public Health Act. The presence of vermin – the bed bug chiefly – may be such as to render a house unfit for human habitation, and in the case of very old houses it may be quite impossible to eradicate them from the premises.

The Housing Act 1930 forced slum clearance and area improvement programmes to house those displaced; it also introduced powers to reduce overcrowding but problems remained entrenched.

The full extent of the tenants’ plight was revealed in the 1935 social documentary Housing Problems.  Tenants present their own narratives of living in slum housing and problems with rat and insect infestations. The film reveals the sheer length of time – sometimes decades – that many families had to endure such poor, sometimes dangerous and decaying living conditions and how they tried to cope with rats, overcrowding, no internal water supply or WC, child mortality, trying to cook next to the bed, with homes decaying around them and how this meant that they had to live their lives.


‘Slum housing’ (1937) (c) London Metropolitan Archives. collage.cityoflondon.gov.uk

However the film also offers hope. It shows two then innovative ideas of new working class housing schemes at Quarry Hill in Leeds (10) and Kensal House in Ladbroke Grove (11). Now suddenly with an option for new housing, tenants describe their excitement and dreams for their new homes. A Second World War was of course not then on the horizon but, for many, their municipal dreams had once again to be put on hold.

Dr Jill Stewart (j.stewart@mdx.ac.uk)


(1) The Sanitary Inspector, 1918: 11

(2) The Historical England webpage First World War: Wartime Architecture provides some useful background.

(3) Addison, C., The Betrayal of the Slums (Herbert Jenkins Ltd , 1922)

(4) Addison, pp62-63

(5) Addison, C., ‘The Sanitary Inspector: his Valuable Work’, The Sanitary Journal, (1922) p104

(6) The Sanitary Journal (1924)

(7) The Sanitary Journal (1922) p202

(8) The Sanitary Journal, The Housing Problem [Referring to Birmingham Daily Post, 3 February 1926], (1926) p148

(9) Swift, S., Housing Administration (2nd ed), (Shaw and Sons Ltd, 1938) p85

(10) See also Ravetz, A., Model estate: planned housing at Quarry Hill, Leeds, (Croom Helm, 1974)

(11) Stewart, J. (2016) Housing and Hope: the influence of the interwar years in England, (available at the iTunes Store)