The Thirties: An Intimate History of Britain

Early diagnosis significantly improved the chance of recovery. The information-aware Bermondsey Public Health Department produced a film for their travelling cinemas, Consumption, in 1932 which illustrated how ‘a consumptive, by placing himself under medical treatment and obeying simple rules of hygiene, can live an ordinary life for many years, without fear or risk to himself or those with whom he comes into contact’. Dr Salter himself played the doctor the patient consults after coughing blood into his handkerchief. He is seen sending the young man to a local authority sanatorium where he gradually gets better and is taught a new trade. On his return home he declines to kiss his wife since he is still contagious, and she makes up a bed for him in a shed in the backyard — provided free of charge by the council.

One way that people might receive treatment was to be admitted to Papworth Village Settlement, near Cambridge, founded by Dr (later Sir) Pendrill Varrier-Jones in 1917 along the lines of Ebenezer Howard’s ‘garden city’ of Letchworth, where, as he explained in an article in 1931, if a tuberculosis patient was found to be ‘suffering from extensive and permanent damage he would be able to live and work permanently in a village settlement with his family. The whole tuberculosis problem would be revolutionised. Those who thought they had tuberculosis would present themselves at a very early stage … and the success rate in treatment would be revolutionised’ — not that Varrier-Jones believed that tuberculosis could be cured: treatment was a life sentence.

By 1938 Papworth, which was infused with the same spirit of experimentation (‘studying the mechanisms of resistance’) and holistic treatment as the Pioneer Health Centre in Peckham — ‘We are dealing with persons, not cases,’ Varrier-Jones was fond of saying — offered a hospital and a sanatorium consisting of open-air shelters with canvas flaps constructed in Papworth’s carpentry workshops for which patients were issued with waterproof blankets to keep off the snow: glasses of water holding false teeth froze solid by the beds. A population of a thousand, including 360 children, lived in the 142 semi-detached cottages to which patients were able to move as they grew stronger, with a verandah and a garden, but no ornaments or wallpaper allowed, as these harboured germs, the windows permanently open. They ate a rich diet that included eggs, milk, porridge and cocoa, and were able to make use of communal facilities such as a swimming pool, join clubs for tennis, cricket, athletics and book reading, and to go to the cinema or pub on site. Since ‘not everyone is fitted for a life in Utopia’, the emphasis was on self-discipline externally policed. Patients lived under a strict paternalistic regime that censored entertainments they laid on themselves and the films they were allowed to watch, and leave passes were rigorously controlled. There was a psychiatric clinic to counsel the despairing.

As well as families, Papworth admitted single men from 1927 and single women (most of them former domestic servants) from 1929, their hostels sited some distance from each other, with ‘a tumulus heaped up’ between them to help maintain segregation. However, several inter-patient marriages did take place, and on such occasions Dr Varrier-Jones would present the happy couple with an engraved glass vase.

Varrier-Jones had hoped that the settlement would become financially self-sufficient through farming and market gardening — and in any case he thought it essential that those that could, should work, or they would soon ‘“throw up the sponge” if they were treated as permanent invalids’. However, the income thus generated turned out to be too little, so he set up a factory turning out travel goods and furniture. Patients were also employed in signwriting, printing, boot repairing and jewellery making, plus some horticulture and poultry farming. By 1930 Papworth’s turnover was £85,000, and by 1937 this had increased to over £130,000, with a number of Cambridge colleges purchasing pieces of the well-made furniture.

The incidence and treatment of tuberculosis provides something of a metaphor for a nexus of 1930s attitudes. The clean, sweeping design of tuberculosis hospitals, sanatoria and health centres that rejected Victorian and Edwardian decoration — curtain rails with heavy plush curtains, flocked wallpaper, cornices and curlicues that might harbour dust and therefore bacilli — the fervent belief in the health-giving properties of fresh air, ‘aerotherapy’ as it was sometimes known, and sunlight, and therefore the use of glass, wipeable venetian blinds, open-air balconies, the curved buildings looking like great ocean liners, such as the expanded Benenden sanatorium, or Harefield hospital, built in Middlesex in 1938 in the shape of an aeroplane floating in the verdant countryside. The Finsbury Health Centre had been explicitly designed to catch the changing angle of the sun, and the interior murals by Gordon Cullen urged ‘Fresh Air Night and Day’ and ‘Live Outside as Much as You Can’.

Flexible interiors were also part of the ethos: Peckham Health Centre had moveable glass partitions which meant that almost whatever they were doing, its members could be observed by the experts like goldfish in a bowl. Such buildings united zealous democratic (and usually socialist) reformist urges with modernist architectural forms that let light into what were formerly dark and hierarchical spaces. Above all there was the debate about what ‘caused’ tuberculosis. Was it hereditary — the Leicester Schools’ Medical Officer was of the opinion that parents with tuberculosis should be prevented from having more children (How? Celibacy? Segregation? Sterilisation?), and the city’s Medical Officer of Health made sure that patients were handed a leaflet when they left the sanatorium advising them not to marry or have children. Was it unhealthy living conditions or an inadequate diet that was responsible? Did poverty cause tuberculosis? Or was it that tuberculosis caused poverty (through lack of earnings)? Could an individual take charge of his or her own medical destiny by clean living, or were environmental factors beyond individual agency responsible?

Average life expectancy was increasing: by 1930 it was 58.7 years for men and 62.9 for women, whereas in 1900 it had been 48.5 for men and 52.4 for women, and infant morality was slowly falling. But this was only part of the story. Relief at the decline in the incidence of infectious diseases (such as tuberculosis) overlooked indicators of poor health such as anaemia, debility and undernutrition, and failed to differentiate between different parts of the country. In fact the death rate was rising: between 1930 and 1931 it increased from sixty per thousand to sixty-six, and in the depressed areas of Lancashire, Teesside, South Wales and Scotland the picture was bleak, with the death rate in the early 1930s as high as it had been before the First World War. Infant mortality rates rose, and not just in the depressed areas. There were marked differences between classes: in Lancashire and Cheshire the number of childhood deaths varied from around thirty-one per thousand among the well-off to ninety-three in the poorest class. Deaths in childbirth were 2.6 per thousand in the South of England, but 5.2 in the North and 4.4 in Wales. Surveys indicated that 80 per cent of children in the mining areas of County Durham and the poorest areas of London showed signs of early rickets, which was put down to both poor diet and lack of sunshine under the smoke-laden industrial skies (hence the preoccupation with sunlight of the health centres); modern estimates suggest that between a quarter and a half of all children living in areas of economic depression survived on a diet that was inadequate to maintain normal growth and health.

The charge that there was a connection between ill health and government policies was consistently contested during the Depression. Again tuberculosis provides an exemplary study, with the Chief Medical Officer of Health, Sir George Newman, attributing the rise in deaths from the disease in the industrial areas of South Wales (from 131 per 100,000 in young men aged fifteen to twenty-five in 1921–25 to 197 per 100,000 in 1930–32, and for young women from 185 to 268 in the same period) to ‘geographical features of coalmining districts’, by which he meant the lack of sunlight in the deep valleys in which the villages were located. He also allowed social factors, such as ‘the tendency to crowd into small rooms and halls, some lack of playfields and facilities for open-air recreation, sometimes an unsuitable diet and the tendency to conceal the presence of tuberculosis’, while for the mortally afflicted young women it was a question of ‘migration to domestic service’ and not returning home until the disease was in its terminal stage. Nonsense, a member of the Committee against Malnutrition riposted: ‘There is no evidence that the valleys are deeper and narrower today than formerly, and migration to service does not account for the increase in male mortality.’

Although the Ministry of Health declined to draw a correlation between poverty and the disease, citing ‘a complex interaction of a considerable number of factors’, those on the ground had no such doubts. A former MoH for Cardiff was unequivocal: ‘Poverty has long been recognised as a prime factor in the causation of tuberculosis, principally through its effect on nutrition,’ he wrote in 1933. A tuberculosis officer for Lancashire, asked to conduct a survey in Durham, concluded that ‘The principal means by which poverty is found to cause tuberculosis are the overcrowding and undernourishment which are the chief distinguishing features between the poor and not poor families [some 3,000] studied,’ and considered the link between tuberculosis and undernourishment to be more significant than that between tuberculosis and overcrowding.

In Jarrow, the death rate from tuberculosis was higher in 1930 than it had been before the turn of the century, at a time when rates across the rest of the country were falling by 50 per cent. The fact that there were fewer cases of spinal, bone and joint tuberculosis in Jarrow than might have been expected could be put down to the fact that fewer of the people who lived there were able to afford fresh milk. (In the 1930s almost 30 per cent of non-pulmonary tuberculosis deaths and 2 per cent of the pulmonary strain were caused by tubercular cows’ milk or infected meat: in 1931 a thousand children under fifteen died of tuberculosis of bovine origin, and many more were crippled, but by the end of the end of the decade still less than 50 per cent of milk was pasteurised.) ‘There is no mystery about the high tuberculosis rate of Jarrow,’ flatly asserted ‘Red Ellen’ Wilkinson, the Labour MP for the town (so named by virtue of both her politics and her flame-coloured hair), scourge of the National Government’s policies towards the unemployed. It was not caused by the supposed facts that ‘“the women do not know how to cook … The Irish have a racial susceptibility to tuberculosis … The families are too large … The geographical formations are unfavourable” … all of which reasons have been put forward by various medical authorities’. Rather, it was caused by the vicious cycle of ‘bad housing, underfeeding, low wages for any work that is going, household incomes cut to the limit by public assistance, or Means Test or whatever is the cutting machine of the time … these mean disease and premature death’.

But still there were those who preferred to see tuberculosis as an individual responsibility, a sickness of advanced civilisation, when the simple life in the fresh air had been abandoned in favour of irregular hours, too little exercise, the stress of modern life, even ‘the thoughtless misuse of leisure time’. All of which were ills that could be rectified by a stiff dose of self-help, rather than costly programmes of social welfare.

As the number of unemployed inexorably mounted month on month to over three million by 1931, politicians, economists, scientists, writers and commentators investigated, pronounced, theorised, constituted themselves into committees and wrote reports, and gathered together to lunch and dine, all in an effort to find reasons for and solutions to Britain’s economic and social problems. In October, November and December that year the BBC invited a selection of prominent public figures to ruminate in front of a microphone on ‘What I would do with the world’. Out of ten speakers, three advocated eugenics.

Lord D’Abernon, a former Ambassador to Berlin and then Chairman of the Medical Research Council, suggested that ‘A wise dictator would devote his attention in the first years of his dictatorship to measures calculated to improve the human race,’ since ‘By excessive latitude given to the weak-minded, by imposing burdens in the shape of taxation on the hard-working to help out the improvidence of the inefficient and less capable, we are doing for the human race exactly what every intelligent breeder avoids in the animal world: we are stimulating breeding from the weak, the inefficient, and the unsound.’ Sir Basil Blackett, a director of the Bank of England, agreed that he would ensure that ‘we make ourselves and the human race better fitted intellectually and physically to use the scientific knowledge which the twentieth century places so freely at man’s disposal’. His programme would make the study of eugenics ‘a compulsory item in the training of every man or woman who is destined to take up administrative service in any part of the world’, while at home ‘we [cannot] afford much longer to follow the aggressively dysgenic course of breeding mainly from the unfit’. Leo Amery, a former (and future) Conservative Minister, decried what he called the ‘short-sighted sentimentalism’ that he felt had characterised the whole trend of British social and fiscal policy in recent years, discouraging ‘thrift and self-reliance’ and encouraging ‘the actual multiplication of the improvident and the incompetent’.

The term ‘eugenics’ was first used by Francis Galton, a cousin of Charles Darwin, in 1883. Its etymological roots lie in the Greek words for ‘good’ or ‘well’ and ‘born’. Eugenics was to be the science (and practice) of improving human stock ‘to give the more suitable races or strains of blood a better chance of prevailing speedily over the less suitable’. The Eugenic Education Society (as it was originally called) was formed in 1907 in order to spread the knowledge of hereditary factors and how they could be applied to the improvement of the race — the ‘self direction of evolution’, as the logo for the Second International Eugenics Conference in 1921 proclaimed. Membership declined after the First World War, but revived again — though never reaching the same level — in the late 1920s and early 1930s, and by 1932 it had reached 768. Obviously this was a select number, but the Eugenics Society never sought a mass membership: rather it aimed to influence the legislative process by permeating the medical profession, the media and universities, and in the 1930s some very distinguished people took an interest in its work, including Julian Huxley, G.K. Chesterton. George Bernard Shaw, J.M. Keynes, J.B.S. Haldane, Richard Titmuss and A.M. Carr-Saunders (Director of the London School of Economics from 1937).

Central to eugenics was the conviction that a large part of those who came to be known as the ‘social problem group’ of the dependent and destitute were the result of genetic defects. But how could this be relevant to the Depression, when the number of unemployed (those who were necessarily economically and socially dependent, and sometimes all but destitute) had risen to three million, since three million people could hardly be congenitally ‘unfit’? How did eugenics shed any light on the fact that unemployment was regional, concentrated in certain industries like shipbuilding, mining and heavy engineering, and not in other occupations?

Eugenicists were sceptical of the notion that poverty and ill health were linked to social and economic factors: rather they blamed the fecklessness and feeble-mindness of the lower orders. Many tended to be persuaded not by the findings of Dr Corry Mann, whose research in the London docklands led him to conclude that poor health was caused by low incomes, and that better pay resulted in better food, with consequent health benefits, but by investigations such as those undertaken by two academics in Glasgow. ‘What is not demonstrated,’ they wrote, ‘is that simple increase in income would be followed by improvement in the condition of children. Bad parents, irrespective of their income tend to select bad houses, as the money is often spent on other things. The saying “what is the matter with the poor is poverty” is not substantiated by these investigations.’

To eugenicists, the ever greater numbers of unemployed served as vindication of what they had ‘known’ all along: the threat posed by the differential birthrate, whereby those of low intelligence reproduced at a greater rate than those of higher intelligence, and the fear that society was threatened by a small minority of the hereditarily inferior who would ‘swamp’ it if they were not controlled. If, as eugenicist doctors such as Raymond Cattell ‘proved’, the unemployed had low IQs, were ‘hereditarily defective individuals’, ‘social inefficients’, as the Eugenics Review had it, they would just go on breeding more unemployables, a veritable ‘standing army of biological misfits’. Unless they were stopped.

The upper and middle classes were clearly producing fewer offspring than those lower down the social scale. For Julian Huxley, the differential birthrate was already dysgenic by 1925: ‘The proportion of desirables is decreasing, of undesirables increasing. The situation must be got in hand. But it is impossible to persuade the classes which have adopted contraceptive methods to drop them by appeal to self-control. The way to stop the rot is to diffuse these practices equally through all strata of society.’ Although the first birth control clinic had been set up in London by Dr Marie Stopes in 1921, and in 1930 the British Medical Association reluctantly gave qualified approval to doctors providing contraceptive advice to married women, the eugenicists feared that it was upper- and middle-class wives who were making rather too effective use of such knowledge, while those who in their view needed it most were confounded by the mess of pessaries, jellies, douches, ‘womb veils’, ointments, douches, tablets, condoms and diaphragms on offer, and relied instead on unreliable methods such as coitus interruptus or unsuitable domestic substances. What was needed was a foolproof means of contraception — preferably ‘the regular consumption by mouth of a substance preventing fertilisation, taken at daily, or better at weekly or monthly intervals’ — which ‘even the stupidest and therefore the most undesirable members of society’ could manage, a Eugenics Society Memorandum concluded.

But ‘the pill’ was decades away, so would ‘diffusion’ mean compulsion? ‘No public assistance without control of birth rates’, the psychologist Raymond Cattell bleakly sloganised. Julian Huxley’s solution to the tendency (as he saw it) ‘for the stupid to inherit the earth, and the shiftless and the imprudent and the dull’, was much the same: to make unemployment relief conditional upon a man’s agreement to father no more children. ‘Infringement of this order could possibly be met by a short period of segregation in a labour camp. After three or six months’ separation from his wife he would be likely to be more careful the next time.’ The zoologist Dr E.W. MacBride, who had managed to ‘demonstrate’ the innate inferiority of working-class children, went further, suggesting in 1930 that ‘In the last resort compulsory sterilisation will have to be inflicted as a penalty for the economic sin of producing more children than the parents can support,’ though he did suggest that before that last resort was reached, ‘Citizens should receive instruction from the State in the means of birth control.’

In 1932 the Minister of Health appointed a committee to make recommendations on the sterilisation of the ‘feeble-minded’ in England and Wales. Under the chairmanship of Sir Laurence Brock, the Committee included three enthusiastic eugenicists, one of whom was Brock himself. After untangling the family histories of so-called defectives and assessing whether they produced feeble-minded offspring themselves, the Brock Committee concluded that a quarter of a million people in Britain were suitable candidates for voluntary sterilisation on account of being ‘mental defectives’. It was unanimous in believing that it was justified in allowing and even encouraging ‘mentally defective and mentally disordered patients to adopt the only certain method of preventing procreation’: sterilisation. In reaching this conclusion, the Committee had privileged any studies that suggested that defectiveness was hereditary — ‘Broadly speaking stupid people will produce stupid children,’ Dr MacBride had asserted — despite dissent from such witnesses as J.B.S. Haldane and Lancelot Hogben, who argued that there could be no scientific certainty on this point, rather that the evidence suggested environmental factors were more likely to be to blame. The Committee did, however, reject compulsory sterilisation.

The Eugenics Society was delighted with the Brock Committee’s findings, and confident that if ‘the general public could be educated to distinguish between sterilization and castration many members of the Social Problem Group would avail themselves of facilities for voluntary sterilization in order to prevent the birth of unwanted children’.

However, no legislation was forthcoming. It was considered that the public was not behind such a programme, the Roman Catholic Church believed that sterilisation violated the God-given right to reproduce, and by the time the Brock Committee made its recommendations in the summer of 1934, the Nazi Party had embarked on a compulsory sterilisation and euthanasia programme in Germany which increasingly discredited the eugenicists and made repugnant to most people the idea of sterilising — even voluntarily — groups and classes of people.

CODA Searching for the Gleam

‘A party of English doctors and scientists passed through,’ wrote the British Consul in Leningrad, Reader Bullard, in his diary on 26 July 1931. ‘Mostly much impressed by what they had seen, and as they had been taken to all the showplaces and nothing else this is perhaps not remarkable.’ The British footfall through the Soviet Union in the early 1930s was, if not heavy, then at least regular and highly questing. Many on the left regarded the Soviet Union as a successful, planned, egalitarian society, the one place where the problems that beset Britain had, as they saw it, been resolved. Those who went made the journey because they wanted to see the Soviet system for themselves, to have their opinions about what was wrong with Britain — the decay of capitalism, the class system, the searing inequalities of wealth and opportunity — confirmed, and to bring some lessons back home. ‘We saw in the Soviet Union the negation of the immoralities of industrial capitalism and the system of private profit,’ the political activist and author Margaret Cole recalled. ‘We were eager to follow the gleam … The hopes for what the makers of the Revolution set out to achieve compared to the dead hopelessness of breadlines and the dole were more than enough to outweigh doubts.’

Sidney and Beatrice Webb went for a two-month tour in the summer of 1932, sailing on the Russian steamer Smolny. As befitted two Fabians and rigorous social investigators, in the months before their departure the Webbs had immersed themselves in ‘Soviet literature of all types … [but] at present we cannot make our way to any settled estimate of success or failure … All I know is that I wish Russian communism to succeed,’ Beatrice wrote.

Lenin had translated the Webbs’ Theory and Practice of Trade Unionism into Russian (‘An example of the quality of boredom being twice blessed,’ thought Malcolm Muggeridge), and by virtue of this the Webbs had become ‘ikons in the Soviet Union’, and were given a superior tour to that allowed to most Intourist visitors, though their itinerary was the usual one: collective farms, schools, clinics, factories. When they came to dine with Reader Bullard (‘At least he came to dinner and she came to two pieces of toast and a glass of red wine. Nine out of ten tourists have their insides upset by bad food, and Mrs Webb is one of the nine’) they explained that they were ‘mainly interested in the organisation of the State, the way the wheels go round, and they seem to have collected a great deal of information’.