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
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