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Category Archives: Public Health

Tackling the Slums: Addison and the Sanitary Inspectors: Part 2, 1914-1939

03 Monday Jul 2017

Posted by Municipal Dreams in Guest Post, Public Health

≈ 8 Comments

Tags

1920s, 1930s

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)

SN Well Hall

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.

Addison Close SN

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).

Sanitary INsp 1922 SN

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.

L0012380 SN

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.

Drain pic MODA SN

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.

249494

‘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)

Sources

(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)

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Tackling the Slums: Inspectors of Nuisance and the Sanitary Inspectors: Part 1, 1848-1914

27 Tuesday Jun 2017

Posted by Municipal Dreams in Guest Post, Public Health

≈ 13 Comments

Tags

Pre-1914

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.

L0073461 SN

No 7 Pheasant Court, Gray’s Inn Lane, from Sanitory Progress [sic], the fifth report of the National Philanthropic Association (1850) (c) Wellcome Library and made available under a Creative Commons licence

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.

L0009845 SN

Lodging house in Field Lane, from Hector Gavin, Sanitary Ramblings (1848) (c) Wellcome Library and made available through a Creative Commons licence

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.

Common lodge text SN

Common lodge pic SN

Both illustrations taken from William Henry Tucker’s Inspector of Nuisance notebook, Cardiff, dated 1899 onward. Permission to copy given by Dr Hugh Thomas, Senior Lecturer in Public Health

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.

249433

‘Boundary Street: slum housing’ (1890) (c) London Metropolitan Archives, collage.cityoflondon.gov.uk

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’.

254127

‘Boundary Estate: Arnold Circus’ (1903) – before the bandstand was added (c) London Metropolitan Archives, collage,cityoflondon.gov.uk

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).

Sanitary Insp 1907 SN

The Corporation of Wimbledon Sanitary Department, 1907.  Reproduced by kind permission of the Chartered Institute of Environmental Health.

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.

L0011651 SN

Plans and pictures of back-to-back  houses in Nottingham, from First Report of the Commission on the State of the Large Towns (1844) (c) Wellcome Library and made available under a Creative Commons licence

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.

249470

‘Grotto Place: slum housing’ (1914) in Southwark (c) London Metropolitan Archives, collage.cityoflondon.gov.uk

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 (j.stewart@mdx.ac.uk)

Sources

(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)

 

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