In an era of minnows and mayflies – politicians whose main agenda is to enrich their families and friends and to court popularity with right-wing newspapers, it’s useful to be reminded that other worlds are possible. In other words, there have been examples of people in high office, in the UK, who have sought to improve society and its institutions for the benefit of the most disadvantaged and who have followed principles that are broader than mere self interest. Liz Truss is not one of them, neither are John Redwood or Jacob Rees-Mogg.
But one such individual was Christopher Addison (not the comedian). A doctor and surgeon who came from a wealthy Lincolnshire farming family, Addison was elected as Liberal MP for Hoxton in London in 1910. His motivation? He had been born into a privileged family and he wanted to help poor people. Sounds improbable? This man walked the walk. In the UK we value delusional flamboyance in our political leaders. We like hucksters. Dull people (Addison was a bit dull, to be honest) are overlooked. Rishi Sunak is dull. But he's the wrong kind of dull – a bean counter who is clueless in the realm of emotional intillgence. Addison was the right kind.
In a career spanning four decades, two political parties and two world wars, Addison's loyalty, his skill in dealing with real-world problems and his unwavering values (yes, there are such things) made him a trusted confidant to three prime ministers – David Lloyd George, Ramsey MacDonald and Clement Attlee. He was a member of Lloyd George's inner circle that that held breakfast meetings to sort out the nation's problems during the First World War, the ‘kitchen cabinet’, and he was so close to Attlee during the next war that the two men were called ‘Clem and Chris’.
Addison set up the Medical Research Council in 1920, legislated for nurses' registration and chaired a committee, in 1931, that recommended the creation of national parks. He shepherded two key health acts into life and was responsible for a piece of legislation, the ‘Addison Act’, that led to the building of an estimated 200,000 council houses. It's a pretty amazing legacy.
How many hundreds of thousands of people have enjoyed better and healthier lives because he was able to translate his princples into practice? But there is no museum in Hogsthorpe, his birth village in Lincolnshire, celebrating his life and achievements. He is mainly remembered through the Addison Act, and a piece of anatomical terminology, ‘Addison's plane’, relating to the abdomen. Other than that, he is almost completelty forgotten.
The reason for his relative obscurity is that Addison was a details person, a pragmatic, behind-the-scenes fixer. While highly principled, he wasn’t a showy orator or a glory-seeker. He just got things done and he came into his own in wartime, when UK governments assumed wide-ranging, command and control powers over people’s lives.
Addison is talent-spotted
When Dr Addison was elected to serve working class Hoxton as an MP, aged 41, he was already a highly-respected fellow of the Royal College of Surgeons, as an anatomist. This new role must, initially, have been a culture shock for a man from a well-off rural background. Plugged into the medical establishment and a master of minutiae, he was soon talent-spotted by Liberal Chancellor of the Exchequer, Lloyd George. He helped Lloyd George to get the 1911 National Insurance Act onto the statute books. It provided compulsory, state-run financial assistance for sickness – Addison’s first health victory.
During the First World War, he was appointed to a key role (ironically for a doctor), in July 1916, as Minister of Munitions. He facilitated healthier conditions for munitions workers and commissioned state-funded estates to house them, with wide streets and generously-sized gardens. This was Addison’s second health victory, excluding those of his medical career.
He was a natural choice to be appointed by Lloyd George, now Prime Minister, as Minister for Reconstruction, in July 1917. The tide of the war was turning and pressing questions pre-occupied the government – where would demobilised soldiers live, what would happen to the economy when ramped up war production was wound down, how would reconstruction be funded and what about social welfare?
The Poor Laws and workhouses still provided a harsh and punitive safety net for the poor. Lloyd George envisaged a radical post-war resettlement. He envisaged something like a ‘welfare state’ after the war – personal social services would be underpinned by state benefits and hated workhouses would be consigned to history. The Local Government Board, the Victorian branch of the civil service that ran the Poor Laws, stood in Lloyd George’s way. The PM simply abolished it, appointing Addison as the man to wind it down.
His bold vision was for a new Ministry of Health. This unprecedented creation would work alongside councils, which would improve and replace slum housing and ensure safe food. Tuberculosis, which thrived in in insanitary, overcrowded living conditions would provide a particular focus for its work. Addison became Britain’s first health minister in 1919, when the Local Government Board was dissolved. The previous year, his Maternal and Child Welfare Act required councils to provide day nurseries for working women – Addison’s third health victory.
His fourth and arguably greatest health victory, the Housing and Town Planning, or ‘Addison’ Act, of 1919, was designed to facilitate a large-scale, post-war house building programme, through a new mechanism, an exchequer subsidy. Addison intended at least half a million homes attractive, affordable rented homes to be built. Less than half that number were achieved. But the act literally changed Britain’s landscape. It must rank as one of the most far-sighted and effective health-promoting measures of the twentieth century.
Eye-catching estates
Small local building firms could be used to construct houses and councils could contribute financially, by levying a rate of up to one penny. Designs were modelled by council architects on the pattern of the Tudor Walters report of 1918, which, had been informed by the arts and crafts housing built by the London County Council, and munitions estates, including Well Hall in Greenwich and Gretna and Eastriggs, in south-west Scotland.
Featuring houses built in short rows, with pitched roofs, large gardens and communal ‘village greens’, the cottage estates of the 1920s and ’30s are still eye-catching. It was healthy, attractive, affordable rented housing for people on low incomes, efficiently-delivered, long before council housing was stigmatised, starved of funding and abandoned by Conservative and Labour governments.
Addison’s fourth victory was to be short-lived. In 1921, amidst alarm from the Treasury about rising costs, Lloyd George slashed the housing programme and humiliatingly demoted his former political ally to ‘minister without portfolio’. Playing up to right-wing newspapers owned by Lord Rothermere, that were soon to turn on him, he accused Addison, in Parliament, of possessing “an unfortunate interest in public health” and of being “too anxious to build houses”.
It's sad when two politicians who function effectively as a political unit – Owen and Steel, Blair and Brown, Sunak and Johnson (they brought out the best in each other) – fall out. Usually, the cause is ego and thwarted ambition – one of the duo begins to resent the other one. In this case, Lloyd George – organisational genius, highwire artist and ladies man – simply ratted on his friend. The so-called ‘Welsh wizard’ valued poll ratings more than his principles and friendships. There is no nice way to put this – he threw Addison under a bus. He did this so as not to lose the backing of the Daily Mail and the Daily Mirror and Rothermere's bizarre political organizaton the Anti-Waste League – a weird combination of the current-day Taxpayers' Alliance and the Nazi party.
Addison was puzzled. He did not resign immediately but brooded for three months, before throwing in the towel. A year later, he lost his seat, in the 1922 general election that obliterated the warring Liberal party – a shock from which it has never recovered. These were Addison's ‘wilderness years’. It was a time for him to tack stock and reflect on what was important. He returned to the family farm in Lincolnshire, and wrote a two-volume primer on socialism and a stinging critique of Lloyd George’s cynical and self-defeating policy u-turn, The Betrayal of the Slums.
In this cogently-argued book, which is still in print, he pointed out that the housing programme’s budget had been arbitrarily reduced to £200,000 for whole of Britain, while the government was spending more than £200m annually on war services. Addison wrote: “The cost of this neglect is that we are committed to an increasing expenditure on combating the results of deplorable housing conditions.”
Return to Parliament
When Addison returned to Parliament, it was as Labour MP for Swindon in 1929. Drawing on his farming background, he served as an agricultural advisor to Labour Prime Minister, Ramsey MacDonald, later reviled as a ‘traitor’ by the unforgiving Labour party. He served, briefly, as a minster of agriculure, in 1930.
MacDonald's hold on power was tenuous. The fascist-leaning Daily Mail had helped to bring down his minority governent in1924, with a forged document, the Zinoviev Letter, alleging a communist conspiracy involving the Labour party.
The global economy was on the ropes. Politics were volatile. In a strong parallel with today, the authoritarian fringes of fascism and communism were finding a home in western democracies. When MacDonald joined the Conservatives in a National Coalition in 1931 – viewed as an infamous move by the Labour party – Adddison resigned from the front bench. He identified as a socialist, but he was not a member of the pacifist, appeasement-favouring wing of Labour, whose leading light, George Lansbury, led the Labour party from 1932 to ’35.
Addison lost his Swindon seat in the 1931 election, regained it in a by-election in 1934, but lost it again in 1935, even though Labour, now led by Attlee, did quite well. It was the end of his time as an MP, but not as a Parliamentarian. He was granted a hereditary peerage in 1937. As Baron Addison, he became one of small number of Labour lords.
In 1945, being one of the oldest statesmen around and a popular figure on all sides, he became Leader of the House of Lords. This was a politically crucial role. His main job, which he skifllfully accomplished, was to steer radical Labour legislation, including a radical nationalisation programme, through the Conservative-dominated upper chamber.
In 1920, as health minister, Addison had commissioned the Dawson report, that had recommended that the UK's hospitals were unified into a single national system and that general practitioners combined preventative and curative medicine. It must therefore have given him enormous satisfaction to advise Attlee and Aneurin Bevan, as the National Health Service Act of 1946 took shape.
The Dawson report had gathered dust on a Whitehall shelf for 25 years, but now, because of Labour's landslide victory of 1945, what was soon to be known as the National Health Service, was being created.
Bricks and mortar legacy
In 1951, Addison tried to persuade Bevan not to resign as labour minister, over the imposition of prescription charges. It was one of his last political interventions. He was ill by then, with the pancreatic cancer that caused his death, aged 82, in December.
Hundreds of people sent messages of condolence to his memorial ceremony at Westminster Abbey, including Winston Churchill. Addison was criticised by his socialist colleagues for his lifelong friendship with Churchill – they had both served Asquith’s Liberal reform agenda at the beginning of the century and, in the 1930s, opposed appeasement with Hitler, against the mood of their parties.
Addison was no Parliamentary firebrand – even his resignation of 1921 received little attention. He preferred to stay in the background, helping to turn the wheels of government. It's strange to relate that biographies of the ‘big beasts’ of politics that he helped and served alongside barely mention him. He must be one of the most least known significant British politicians of the twentieth century.
It could be said that his most tangible legacy was the council housing of the inter-war period, embodying his conviction, which is as relevant as ever, that investing in sound, affordable rented housing can help to level up social inequalities and reduce the incidence of wholly preventable illness.
In the first health minister’s second constituency, Swindon, there is an Addison Crescent, one of more 90 streets in Britain, all in areas of social housing, that bear his name. I think that Addison would be pleased by that. Perhaps bricks and mortar is best legacy to have.
Will Hatchett has been a social policy journalist since 1986. He was editor of Environmental Health News from 1998 until 2018. The views expressed here are purely his own. This blog draws on his chapter on Christopher Addison in Pioneers in Public Health: Lessons from History, Ed. Jill Stewart, Routledge, 2017.
Pic shows Addison Road, Allenton, Derby, thanks to Municipal Dreams
This blog was written for RHE Global
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