The Importance Of Social Reformers

Two key figures you must know about are Charles Booth and Seebohm Rowntree. At the end of the 19th century, despite vast increases in wealth, an idustrialised economy and an empire covering a quarter of the globe, the disparity between rich and poor in Britain was as bad as ever. These two men set about trying to change that by shining a spotlight on the appalling poverty which plagued the major towns of the country and in so doing, they demonstrated the link between poverty and poor health.

Charles Booth

Booth was a successful businessman with a deep social conscience i.e. he cared deeply about the problems of society, specifically the poverty that characterised late Victorian Britain. Over a 17 year period he analysed the poorest sections of London and between 1892 and 1902 he published a series of reports on the living conditions for people in London, the last one was entitled: Life and Labour of the People in London.
In them Booth documented in minute detail the housing conditions people lived in, number of people per house, the jobs people did, the working conditions they toiled under and the money they earned. He and his team of investigators then produced maps coloured coded to indicate the levels of poverty in London. Streets marked as black or dark grey indicated extreme poverty.

The core message Booth was pushing out was that 31% of the people in London lived in poverty of some kind and that the goverment should take an active role in ending this extreme poverty and thus he was proposing an early form of socialism. Booth was advocating that the government should gaurantee a minimum standard of living for all its citizens, which no one should fall below.
A specific example of the influence he had was on state pensions. Booth argued that the goverment should provide a universal state pension (i.e. everyone gets it) to reduce the extreme poverty many found themselves trapped in after they stopped working. Previously it was only handed out to those in extreme poverty but Booth argued everyone should get it. The Liberal government in 1908 duly enacted the Old Age Pensions Act which gave everyone over the age of 70 a pension. The 1908 Act is widely seen as the start of the British welfare state.

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Seebohm Rowntree

Rowntree was working on a similar idea to Booth, but focused not on London but his home town of York. In 1901 he published ‘Poverty: a study of town life’ and his work revolved around the idea of a ‘poverty line’ which he measured people against. This was the amount of money he felt someone would need to stay out of poverty and he was thus able to argue that about 44% of the population were poor because they fell below that income line, but a staggering 28% were extremely poor i.e. they lacked enough money to cloth and feed their families. His report was read widely across the country (thanks in part to his tour around the UK giving lectures to promote it) and influenced many politicians that changes were needed.
Crucially both men argued that for the vast majority of the poor, it was not their fault. The chief wage earner might be disabled or dead, or if they were employed they were paid very little. This helped change attitudes (see point 2 below) that they deserved help. Previously the attitude of many was that they were in poverty because of their own failings.

The importance of Booth and Rowntree to a study of the history of medicine is significant for 3 reasons:

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1. Their work shocked the country. Few of the well to do middle and upper classes had much contact with the poor and were profoundly shocked at Booth and Rowntree’s descri ptions of the living conditions the poorest had to endure. This shock acted as a trigger to pressure the government into action.

2. They argued that the government could and should intervene to improve the lives of the poorest in the community, thus establishing the principle that the goverment had a duty to help in other areas as well: for example the provision of better health for the people. Their work helped to change the mindset of what people expected from the government. From the largely hands off approach that limited their interventions in previous centuries, now Booth and Rowntree were helping to change people’s attitudes towards the view that the goverment must intervene to help. Once the principle had been established that the government had a duty to help, future health reforms and interventions (detailed in this chapter) were therefore much more likely to happen.
3. By encouraging the government to try to lift people out of poverty and improve where they lived and worked, they simultaneously improved their health. Booth and Rowntree had helped to reinforce the idea that poverty led to bad health. The terrible living conditions, the dangerous and unpleasant jobs many were forced to do, the poor diet that came from low wages, all played a huge impact on the health of the poorest. Lift them out of poverty and you reduce sickness and disease. As the government intervened to improve housing, to improve working conditions to give them basic incomes throughout their lives, so the ill health that stalked previous generations was slowly eradicated.

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The impact of their work:
Their work, along with the problems of finding sufficiently healthy volunteers to fight in the Boer war, were a key reason for the sudden flood of social reform initiated by the Liberal party, in power from 1906-1914. 
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As noted above, all these changes had a profound impact on improving the health of Britain in the 20the century and also laid the groundwork for the many major steps forward in public health in the 20th century that were to follow.

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Boer war:
The Boer war had highlighted the physical failings of many of the poor who would otherwise have been drafted into the army and the continued inability to beat the Boers (in South Africa) meant that Rowntree’s report in particular struck a chord with so many as the explanation for Britain’s continued military ineptitude. So the context of when the reports were published (against the military failing during the Boer war) is very important to understand why both sets of reports had the impact they did.



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