Do you think that’s wise, Mr President?

The first presidents of environmental health’s professional body, all knighted, were an extraordinary group of people – nationally famous, single-minded and highly successful in their fields. One of them was ‘the last of the great Victorians’, another met Mark Twain.

 

No-one could accuse early presidents of the Sanitary Inspector’s Association, later the Chartered Institute of environmental health, of not being famous, or important. The first seven of them, forming an unbroken chain from 1883 to1938, were knights of the realm.

 

Reviled by some, admired by many, but never ignored, the first president, Sir Edwin Chadwick, (pictured) was one of the most celebrated public figures of the 19th century. In an age when cholera and other waterborne diseases were prevalent in towns and cities, Chadwick, a privately-tutored Manchester-born barrister and follower of the utilitarian philosopher, Jeremy Bentham, was obsessed about terrible state of London’s refuse collection and sewers.

 

His self-financed report on the sanitary condition of the labouring population of Great Britain was so forceful and persuasive that it led to a royal commission and, in turn, the Public Health Act of 1848, arguably the first piece of legislation of its kind, directing the full powers and insitutions of an industrialised state to making its citzenry healthier, in the world. Chadwick was instrumental in the setting up of the Metropolitan Commission of Sewers, which was to direct, only ten years later, the creation of London’s first extensive sewer network – a measure that saved hundreds of thousands of lives.

 

Chadwick was also a social reformer – but he deserves fewer plaudits in this area. He was an architect of the 1834 Poor Law, whose central idea was to make workhouse unpleasant and punitive institutions, to discourage poor people from entering them.  So – sewers great, workhouses terrible. One out of two is not bad.

 

Chadwick whose surprisingly small walking stick was formerly displayed in a glass case in the CIEH council chamber, was dogmatic, obsessive and dictatorial. “We prefer to take our chance with cholera than be bullied into health,” said a famous diatribe against his sanitary reforms in 1854, in the London Times.

 

By the time this Victorian grandee became the first CIEH president, in 1883, he was 82 years old. Even now, Chadwick clung to the long past its sell-by-date ‘miasma’ theory of disease (a belief, inherited from ancient Greece, that illness was caused by an invisible gas rising from rotting matter). He had been right about sewers, that poor sanitation made people ill, for the wrong reason.

 

He also believed that crime was caused by insanity and that a large proportion of orphaned children were the offspring of “hereditary vagrants, mendicants and delinquents”. But London’s improved sewers, it is estimated, had raised average life expectancy in the capital by 20 years, so let’s not judge him too harshly.

 

Hygeia: a city of health

 

As president, he was a tough act to follow. Step up to the plate, Sir Benjamin Ward Richardson. A fellow of the Royal College of Physicians Richardson was a pioneer of forensic medicine and anaesthesia. He brough into use no fewer than fourteen anaesthetics. A strict abstainer from alcohol and campaigner for healthier food, he had had multiple public heath interests. As CIEH president, he led many deputations to the Local Government Board to argue for security of tenure for sanitary inspectors.

 

Richardson was a prolific writer of papers, biographies, plays, poems and songs. His Hygeia, the pamphlet of a talk that he delivered in 1875, is a fascinating piece of science fiction. It describes a purpose-built ‘city of health’. A population of around 100,000 would live on approximately 4,000 acres of land, with houses restricted to four storeys, in wide streets. The houses would be made from coloured glazed bricks, to facilitate cleaning, and have no cellars or basements – basement  dwellings and workshops were the bane of the nineteenth century sanitary inspector.

 

Hygeia would be served by underground trains and furnished with swimming pools, Turkish baths, playgrounds, gymnasia, libraries, lecture halls, municipal slaughterhouses and water and gas supplies. Factories would be separated from residents. Ozone would be passed through drinking water and diffused through the houses to disinfect them. Richardson was not a miasmist, he believed in the new germ theory – bacteria were known about but not yet viruses.

 

He predicted that, in his healthy city, dysentery, typhus, typhoid and cholera would be almost unknown, scarlet fever, whooping cough and tuberculosis reduced and smallpox ‘kept under control’. There are parallels for Hygeia in industrial villages, like Bournville and Port Sunlight, and Letchworth Garden City but it preceded all of them. The idea is still ahead of its time.

 

Written long before town planning had been thought of, it is a remarkable feat of imagination. In the days before the nano specialisms of today, scientists could be polymaths. They could present their latest idea as a dream,  a play or a classical allegory. It’s also significant that a famous scientist and physician of Ward’s stature would assume an honorary position of a body devoted to sanitary science – medicine (treating people after they are sick rather than preventing sickness) had not assumed the virtual monopoly of health that it has today.

 

Publishers as presidents

 

For the third name on the honours board of ex officio appointments that once hung in the hallowed CIEH council chamber, let us move to Sir John Hutton. Hutton was a publisher of newspapers and journals, including Sporting Life and the ABC Railway Guide. A London county councillor, serving for the Progressive party, and a campaigner for parks, known for dedicating Hackney Marshes as an open space, when he was chairman of the London County Council, a position that he held from 1892 to 1895.

 

Interestingly, the fourth CIEH president also came from the publishing world and was even wealthier. Sir Hugh Gilzean Reid was descended from a long line of Highland crofters. Self-educated, he studied to become a non-Conformist minister but transferred his primary interest from religion to business, through journalism.

 

Gilzean Reid, the first president of the Institute of Journalists, became editor of the Edinburgh Weekly News, and in the early 1860s, founded the Middlesbrough Daily Gazette, a highly successful halfpenny evening newspaper. This made him his fortune. In 1885, he was elected as MP for the Aston Manor constituency in Birmingham, as a Liberal.

 

Gilzean Reid was the local MP for HH Spears, who was then, aged 19, working his way up the environmental health career ladder. It seems highly probable that Spears suggested Gilzean Read as a likely president of the association, following Sir John Hutton, in 1899.

 

Enter Mark Twain

 

Life has some strange twists and turns. From 1897, Gilzean Reid, took up residence in the splendid Dollis Hill House in Willesden, north London. Standing in extensive grounds this villa, now demolished, had asociations with Liberal prime minister, William Gladstone, as well as Joseph Chamberlain and Lord Randolph Churchill.

 

In the summer of 1900, the celebrated American author Samuel Langhorne Clemens, aka Mark Twain, was Gilzean Read’s house guest. Twain wrote that he had "never seen any place that was so satisfactorily situated, with its noble trees and stretch of country, and everything that went to make life delightful, and all within a biscuit's throw of the metropolis of the world”.

 

HH Spears,  editor of The Sanitary Journal visited him there too. There is a reference to their meeting in the publication. Did they reminisce about the old days, in Aston – a place of densely packed slums and smoke-belching chimneys, where the sun rarely penetrated. Gilzean Reid was in his pomp, a British version of William Randolph Hearst. The celebrated publisher only served as CIEH president until 1901. He died in 1911, aged 75, following a motoring accident from which, Spears tells us, he never fully recovered.

 

First woman on the board - hurrah! But is it too late?

 

He was succeeded as president by Sir James Crichton-Browne, who served from 1902 to 1921. Known as ‘‘The Last of the Great Victorians’, Crichton-Browne, who had walrus-like whiskers and was a world authority on lunacy, deserves a blog to himself, as does the first female president, the remarkable Janet Russell. She was elected in 2012, 129 years after Chadwick. The CIEH has now had three female presidents, bringing a century of male domination, at least in that role, thankfully to a close.

 

Battle for professonal recognition, from the town hall

 

Frustrations, membership rebellions and existential crises and are nothing new to environmental health’s professional body. They have occurred with surprising regularity over the past 140 years.

 

Environmental health practioners – people who work for councils and private companies who carry out food, health and safety and housing inspecctions – are practical, knowledgeable people. They know how important they are, even if the wider world doesn’t. Their work keeps people alive, but they don’t have the kudos, or the salaries, of the folks in white coats. They don't make a big song and dance about things. They just get on with it.

 

They wouldn’t expect the wider world to notice their fierce arguments and impassioned debates, governed by esoteric rules of procedure. They would probably be embarrassed if it did. This month’s blog is about an event that almost split the membership body for environmental heath apart. It occurred in 1918.

 

The disparity between the low status of inspectors and their vital role came to head, from the 1880s, as fast-emerging discoveries of germ theory and microscopy unlocked the secrets of disease. Inspectors had one foot in the drains and the other in the world of science. In their monthly journal, they read about topics including the latest theories on what caused TB in cows and human, the dangers of house dust, flies and flock-filled mattresses and the chilling and now discredited theories of eugenics.

 

Inspectors’ work was to inspect premises, serve notices and seize unfit food – a task that required, as today, knowledge of both practical matters and the law and powers of persuasion and, at times, discretion. Speaking in 1910, president of the Sanitary Inspectors’ Association, Sir James Crichton-Brown, summed up the inspector’s role eloquently (it’s a quote worth Blu Tacking to your wall: “They see, more than other men (yes, there were women too) except the police and the more devoted of the clergy, the dark and gruesome side of life of the clotted masses of squalor and misery that clog our civilization and yet they do not commit suicide or sink into melancholy or misanthropy, but push on with their work, undismayed and full of hope … the sanitary inspector who was asked what a sanitary inspector inspects replied ‘everything’.”

 

A bit special

 

So, yes, they were a bit special. Was not an eminent and knighted pioneer of neuroscience, the president of their professional body? No wonder inspectors felt somewhat resentful of the status of doctors, whose interests in the poor were often largely pecuniary and the medically-trained medical officers of health under whose direction they worked – professionals who knew the theory of disease but not necessarily the practice.

 

In an era in which outbreaks of typhus, typhoid and diphtheria were still common, their work provided the house-by-house and street-by-street data for their MoH’s annual reports (these documents, with their lists and statistics, provide fascinating insights into the diet, health and aetiology of Victorian and Edwardian Britain – the lives and deaths of ‘ordinary’ people).

 

Edwardian Inspectors earned £50 a year or less – little more than a skilled artisan – and they could be sacked on whim by councils, for example, if they had offended a wealthy local landlord or farmer, who might also be a magistrate.

 

The issue came to a head in the First World War. Inspectors who did not join the services or were called up worked in denuded departments, in an even more frenetic and thankless battle against disease. There had been partial national insurance since 1911 but doctors had to be paid for. For the urban and rural poor, clean food and good drains were by far the most important factors in life preservation.

 

The Sanitary Inspectors’ Association, which had begun in 1883, came up with a cunning plan. There was a good case, surely, for its members to form a quasi-national health service. But, for this to happen, they would need to be given reserved occupation status, exempting them from military service, and security of tenure and pension rights. In June 1914. The association sent a delegation to Westminster to press its argument.

 

Silver-tongued Lloyd George

 

The delegation was met by no less a person than chancellor of the exchequer, David Lloyd George, who was to become prime minister in 1915. Silver-tongued Lloyd George said that he had never heard “a more persuasive case”. But he did nothing. He had never intended to do anything. Lloyd George did not like councils, which he saw as ineffective and compromised by political influence, or their lead institution, the now antiquated-seeming Local Government Board, a body that also ran workhouses and the vestiges of the Poor Laws.

 

The Welsh wizard had bigger fish to fry. He was to abolish the LGB in 1915 and to overee the creation, in 1919, of a shiny new Ministry of Health, headed by the UK’s first health minister, Liberal MP Christopher Addison. This forward-looking institution was to provide the paradigm for post-war health in Lloyd George’s masterplan. He did not anticipate a prominent role for the sanitary inspector.

 

In the trenches of the Great War, inspectors built pit latrines, disinfestation stations and washing facilities for soldiers, working for commissioned officers who were often MoHs on civvy street. They were little more than labourers, still on the wrong side of the social divide. The war ground its way to a weary conclusion. It had unleashed powerful forces and expectations of change – catalysing a revolution in Russia and rent strikes on Clydeside that were feared by the British establishment to be a domestic version of Bolshevism.

 

In June 1918, the association sent a second group to Westminster to argue for professional recognition. This time the senior official who the delegation had expected to meet, head of the Local Government Board, Hayes Fisher, did not even bother to turn up, citing “important business elsewhere”.

 

Crushing humiliation

 

It was a crushing humiliation – not least for HH Spears, chief sanitary inspector for West Bromwich and editor of The Sanitary Journal. Over the course of the war, his frustration had grown that a vital segment of Britain’s health workforce, sanitary departments, were being overlooked. His bitterness grew after May 1917, when his son, Eric, was killed at the Second Battle of Arras – one of more than 700 servicemen to lose their lives on the same day.

 

A revolution had been quietly simmering at the association’s grass roots. Since 1915, in England’s industrial heartlands, the Soviet-sounding ‘joint committee of North Western Centre and the Manchester Sanitary Inspectors’ Branch of the Workers’ Union,’ frustrated at the association’s lack of success in achieving recognition, had been calling for radical change.

 

In July 1918, a sanitary inspector from South Wales, Eric Whone, took up the committee’s call. He argued, in a letter to the journal, that the association “is not competent nor capable of achieving for its members those essential benefits that they have a right to expect”. Noting the success and influence of the National and Local Government Officers Association (NALGO), founded in 1905, he called for the association to be dissolved and reconstituted as a trade union, affiliated to the Labour party.

 

Spears feared a civil war. He responded nervously that “overwork and continuous worry have put men’s nerves on edge” and called for more discussion on the issue. However, he announced that a referendum would be held of the entire membership. It would be worded simply – “are you in favour of the Sanitary Inspectors’ Association being re-organised as a trade union?”.

 

The referendum was duly held. The motion was lost. By then, people’s minds were on other things. The proposed health ministry seemed to betoken a more caring world. There was talk of a mass housing programme and of new maternity and childcare services. Still seeking greater official acknowledgement of its role, the association moved on. Spears retired from his West Bromwich post in 1934.

 

A well-liked figure, he remained as editor of The Sanitary Journal until 1943, having overseen it for 36 years and through two world wars. Spears had a hinterland – he was an amateur naturalist and a playwright. He died in 1950, aged 84. 

 

This blog appears on the RHE Global website

 

Will Hatchett has been a journalist since 1986. He was editor of Environmental Health News from 1998 until 2018. The views expressed here are purely his own