Comparing these figures with those for 1891 it appeared that—

“A marked improvement had taken place in the manner in which persons occupying tenements of less than five rooms are housed in London. The shifting of the population in the ten years from the tenements of one or two rooms to the more ample accommodation provided in tenements of three or four rooms is conspicuous.”[195]

There had been a reduction in the number of one-room tenements, which are justly regarded as the worst of all from 172,503 in 1891, to 149,524 in 1901, whilst there had been an increase in the number of two, three, and four-room tenements.

As to the numbers of persons living in these 672,030 tenements—

Still, therefore, well over half the population of London lived in tenements of less than five rooms; whilst over 1,000,000 lived in tenements of one or two rooms—and between one- and two-room tenements there is not much to differentiate.

By further details given (as in 1891) each Sanitary Authority was “provided with the means of examining with much precision into the house accommodation of its district.”

The Medical Officer of Health for the Borough of Finsbury, utilising the figures for that Borough, deduced some most instructive conclusions as to the effect of the one-room and two-room tenements upon the death-rates.

Forty-six per cent. of the population lived in such tenements; the death-rate in one-room tenements was 38·9 per 1,000; the death-rate in two-room tenements was 22·6 per 1,000. And the number of deaths occurring in them was 63 per cent. of all the deaths in the Borough.

“The conditions of life obtaining in one-room tenements,” he added, “are such as tend towards poor physique, disease, and death. The density of population is higher, the physical restrictions are greater, and there is less fresh air and more uncleanliness.”

The information thus given by the Census Commissioners as to tenements was striking enough, but of deeper interest and import even than these figures was the information as to “Overcrowding.”

The Medical Officer of Health for the London County Council, utilising the figures of the census, worked out the facts as regarded the overcrowded tenement population of London.

There were 726,096 persons living in an overcrowded state in 124,773 tenements of less than five rooms. Of these—

There had been a reduction of overcrowded tenements from 145,513 in 1891, containing 829,765 persons, to 124,773 in 1901, containing 726,096 persons.

There would appear then to be some hope that the acme or climax of overcrowding has been passed. But even from the most sanguine point of view the improvement is not great, and many decades would have to elapse before “overcrowding” ceased to be a power for evil.

A few illustrations show the dreadful condition of things in this respect in certain localities.

In the Borough of Finsbury, over 35,000 persons lived in overcrowded tenements of less than five rooms; in Stepney, 99,000; in Islington, 56,000; in St. Pancras, 56,000; in Lambeth, a few short of 37,000; and in Southwark, over 46,000.

And if some of the figures about overcrowding were looked into a little more minutely it was to be seen that in St. Marylebone there were 1,020 two-room tenements inhabited by five persons each, 685 by six persons each, 366 by seven persons each, and 170 by eight persons each.

In Islington there were 1,253 such tenements with six persons each, 624 with seven persons, and 258 with eight persons.

In St. Pancras there were 1,414 two-room tenements with six persons in each, 743 with seven persons in each, and 323 with eight in each.

In Shoreditch there were 694 two-room tenements with six persons in each, 380 with seven in each, and 155 with eight in each.

Stepney was the worst of all—with 1,126 two-room tenements with seven persons in each, 577 with eight persons in each, and 278 with nine persons in each; but this was the result of alien immigration.

In Lambeth there were 699 tenements of two rooms with six people in each, and 322 similar tenements with seven each, and 118 with eight each.

It must have come as a revelation to many of the Borough Councils to find such a condition of things existing in their municipality.

These are the most recent reliable figures. Not much change can have taken place since then, and they may be regarded as presenting fairly well the existing condition of the housing of the people of London.

The main fact emerging from them is that a population of 726,096 persons in London are living in 124,733 overcrowded tenements of less than five rooms.

The accumulated testimony of the most experienced and capable observers during half a century is clear and precise that overcrowding is disastrous to the physical welfare of the individual. The conditions of life are not much better in one- and two-roomed tenements, and the conclusion is thus forced upon us that, speaking broadly, a fifth of the population of London are at present living in circumstances where physical well-being is impossible, and where even a moderate standard of public health is unattainable.

For some time back, fears as to the physical deterioration of certain classes of the population have found public expression, and to such a point did these misgivings come that, in 1903, a Committee was appointed by the Lord President of the Council to inquire into the subject throughout the kingdom.

The idea of physical deterioration being at work found expression sometimes in the reports of the Medical Officers of Health even far back. Thus, in 1869, the Medical Officer of Health for Paddington wrote:—

“In Paddington overcrowding in its worst forms cannot be said to exist, but there is an over-concentration of building which will some day be considered a disgrace to our civilisation. It may safely be predicted that besides a high infantile death-rate a concomitant deterioration of race will result…. This high (infantile) death-rate is not the only check to population. Another and more painful form of evil manifests itself in the sickly and puny race around us. Young men and young women are unable from low vitality to cope with their contemporaries in the labour market, where prolonged muscular exertion is required. We find in this class the seeds of debility and disease.”

In 1871 he gave a table with particulars of five hundred heads of families of the wage-earning class engaged in industrial occupations living in tenement-houses in certain streets near the Great Western Railway terminus. “Sixty-four per cent. were born in country places. This,” he added, “confirms my statement in former reports that large numbers of men born in cities have poor constitutions and deficient vital stamina, who cannot cope with their competitors from the country, nor command the best labour markets of the world. In the struggles of town-life large numbers are prematurely crushed out at early periods of their existence.”

And he added: “This deterioration of race has for some time been recognised by Medical Officers of Health.”

Unfortunately the conditions of life conducive to deterioration did not cease to exist in 1871, as evidenced by the figures of the censuses of 1891 and 1901, of the population living in overcrowded tenements of less than five rooms.

The Committee reported in 1904, but while both the Report and the evidence are of great interest, it cannot be said that they advanced the question much.

The Committee stated that—

“There are no sufficient ‘data’ at present obtainable for a comparative estimate of the health and physique of the people.”

That being undoubtedly so, the best light obtainable on the subject must be sought for in a different way. Fortunately that way exists—and it is possibly the soundest of all—the method of inference from well-established facts.

The reports of the Medical Officers of Health for London during the last half-century enable this method to be applied to London.

In cases innumerable it has been demonstrated beyond dispute that the death-rate was highest in overcrowded houses or localities, that the sick-rate was proportionately higher, that disease assumed more virulent form in them, and left the victim in a more impaired condition.

“It is almost an axiom that the greater the crowding, the greater the sickness and the higher the death-rate.”

That these conditions affect the health and stamina of persons of all ages, and more especially of the children who are to constitute the new generation, is a truism, and thus the health and stamina of a large proportion of the population is, of necessity, damaged and deteriorated, and a heritage of suffering and debility passes to a succeeding generation. Were these evils mere passing events like an epidemic of cholera which sweeps away its thousands of victims and is gone, the results would not be so disastrous.

But when to these clearly proved facts is added the awful fact that these evils have been unceasingly in active operation for considerably more than half a century, that the past is still exerting a powerful and pernicious effect upon the present, and that the seeds of evil then sown are still producing a deadly crop, it is a necessary and unavoidable conclusion that there has been a considerable deterioration of race.

Counteracting these deadly forces have been those which have been described in this book:—

Efficient sewerage and drainage, water supply improved in quantity and quality, sounder food, wider thoroughfares, cleaner streets, open spaces, new dwellings, prevention of the defilement of the atmosphere, prevention of the spread of infection—all these, together with better knowledge of health matters, the vast advance in medical science, the better provision for the treatment of the sick, greater temperance, and the great work carried on by numerous philanthropic workers and organisations, have effected vast improvement—an improvement testified to in the fall in the death-rate of London from 23·38 per 1,000 in 1851 to 17·1 in 1901 since which year it has further decreased.

Painfully and laboriously, and in the face of persistent obstruction and hostility, has the present sanitary position been attained. “Vested rights in filth and dirt” have offered a prolonged and dogged fight against reforms which curtailed their privileges. Hundreds of thousands of lives have been needlessly cast away, an uncountable number blighted and made useless by diseases which were preventable, and which were not prevented, and an incalculable injury inflicted upon the community.

And the expense to the community has been enormous. Millions upon millions of money have had to be spent to make good—so far as could be made good—the ravages of past neglect and culpable management. Millions upon drainage, upon hospitals, upon houses for the working classes, upon open spaces—tens of millions upon water supply, and most unjustifiable and regrettable of all, millions to compensate slum owners for their iniquities.

And even yet we have not arrived at our goal. What, then, are still the causes of failure? What the impediments? Where the shortcomings?

The failure is in part due to a great omission by Parliament—in part to the non-administration of existing laws by local authorities—in part to a great defect in the system of local government.

Parliament had, most unfortunately, omitted from all its enactments affecting London any provision for the supervision of the great movement in part economic, in part social, which has been going on in London for well-nigh two-thirds of a century—namely, the change of houses inhabited by one family into tenement-houses, or houses inhabited by several families.

That movement with its appalling attendant evils was allowed to go on practically unregulated, uncontrolled, and unsupervised.

The great evil of this movement was, that a house which had been structurally and sanitarily designed for one family was sanitarily unsuited for its altered career as the abode of several families. Nothing was done to obviate this evil. And so these houses became packed with people and families who had to live in one or two rooms in them without the primary necessities of a healthy existence—without ventilation—without an adequate supply of water—without facilities for cooking food—with the scantiest and filthiest sanitary accommodation—had to live under conditions which put a high premium upon dirt and insanitation, and which absolutely invited disease and death.

Even the Sanitary Act of 1866, and its amending Act of 1874, did not deal with this crucial matter; and no legal obligation was created by Parliament to ensure that the houses undergoing such a change should be adapted to their altered circumstances.

The Sanitary Act of 1866 only in part dealt with the evils inherent in such houses. It imposed on the Sanitary Authority the duty of making regulations which prescribed a standard of the air space for each person, and thus made an effort to prevent overcrowding; it imposed upon the “owner” the duty of maintaining a certain standard of cleanliness—the rooms were to be painted or lime-whitened every year—it laid upon the tenants certain duties also as to maintaining cleanliness.

But even this imperfect legislation was completely brought to naught by the opposition of the Vestries and District Boards to such action as would have secured at any rate some degree of decent accommodation in the tenement-houses of London.

By the Public Health Act, 1891, the London County Council was empowered to make bye-laws enforcing a certain standard of sanitary accommodation in them, and did make them. But in other respects nothing was done; and so the process still goes on, large numbers of houses hitherto occupied by one family are passing into the occupation of several families devoid of the primary necessaries of a healthy existence. The great movement has by no means spent its force; for long to come houses will be going through this transition, and until legislation deals definitely with this matter the inevitable evils attendant on the change will continue.

The second main cause of failure lies at the door of the local authorities who would not and did not administer the existing laws.

The local governing authorities are now more active than they have ever been before; the amount of work done in every branch of sanitation is far greater than ever before; the number of Sanitary Inspectors has been increased from 188 in 1893 to 313 in 1904. But the regulations or bye-laws under the Act of 1891 which Parliament had imperatively directed them to make and to use as regarded the tenement-houses in London, are very far from being enforced to the extent they should be.

The total number of houses let in lodgings which were on the various registers in 1905 was 22,257.

With only a few exceptions the Borough Councils, like their predecessors the Vestries, make comparatively little use of this power, though there is a concurrent mass of testimony as to the beneficial results following its use. Stepney, under the inrush of aliens, found the benefit of exercising the power, and heads the list with 2,672 houses on the register. Kensington has 2,107; Westminster 1,641; St. Pancras 2,192; Hammersmith 2,266; and Finsbury 1,169. These amount to 12,047, or 10 per cent. of all the inhabited houses in those six boroughs. In the whole of the rest of London with 451,596 inhabited houses, only 10,207 of the houses let in lodgings are registered: so that only 2¼ per cent. of the houses in them, as against 10 per cent. in the others, are registered.

It is manifest, therefore, how imperfectly the greater number of even the present local authorities perform the duty which has been imperatively imposed upon them by Parliament.

The Borough of Shoreditch, for instance, with 22,940 tenements of less than five rooms, of which 6,269 were overcrowded with 35,500 persons living in them, has only 283 of the houses let in lodgings on the register. The Borough of Lambeth with 44,495 tenements of less than five rooms, of which 6,548 were overcrowded with 36,900 people living in them, had only 372 houses on the register. The Borough of Bermondsey with over 25,000 persons living in overcrowded tenements had only 221 houses on the register.

This, as has been explained (see p. 377), is not a matter in which the Central Authority, the London County Council, has any authority to interfere. The Borough Councils are their own masters in this matter, as were their predecessors the Vestries, and the responsibility as to administering or not administering in their areas the Act of Parliament rests entirely with them. The consequences of the non-administration of these bye-laws to the health and physical well-being of great masses of the people are disastrous.

Various legal decisions in recent years have somewhat impeded the effective administration of the bye-laws in this matter, but the real impediment is the dislike to them of the Borough Councils.

The condition of the vast tenement-house population in this great city is of such immeasurable consequence to the community at large that matters can only be allowed to continue in their present most unsatisfactory state at the most dire cost. The sooner it is thoroughly inquired into by Parliament and drastically dealt with the better; great evils will be stayed, great benefits will be secured.

The third principal cause of failure to attain a higher level of the public health in London than at present enjoyed has been the want of a real central Health Authority. The Metropolitan Board of Works was never such. The London County Council is only such in a very limited way. A real central Health Authority for London is an absolute necessity—that is the great moral to be drawn from the history of the last half-century so far as local government in health matters in London is concerned.

Disease recognises no boundaries, and in a great city like London it is essential that in so vital a matter as the public health full authority should, subject to Parliament, be vested in one supreme authority—a central authority which shall secure uniformity of administration; a central authority which shall be able to compel a local authority in London to do that which if it neglects is a danger to the community; a central authority which, in the event of such neglect, shall be authorised itself to undertake that work; a central authority which shall be able to act at once for London as a whole in presence of any sudden or great emergency—that is absolutely essential for the sanitary safety of this great city and of the millions who live in it.

The want of such an authority has throughout the whole sanitary evolution of London been a disaster of the greatest magnitude, and is an ever-present peril to this great metropolis. The existence now of a central popularly elected representative body for the metropolis would render this reform quite a simple matter.

Further measures are also required to aid in the removal of the worst of London evils.

In 1903 a Royal Commission was appointed to inquire into the means of locomotion and transport in London. It reported in 1905, having done its work more thoroughly than even most Royal Commissions do their work.

A great portion of its report deals directly or indirectly with the sanitary condition of the people of London.

“The question of locomotion,” said the Commissioners, “affects the health, comfort, and efficiency for work of the whole community….

“Witnesses who have special knowledge of the subject are of opinion that the remedy for overcrowding is to be found in the removal of the people to outside districts by providing additional facilities for locomotion, and in this opinion we agree….

“We have come to the conclusion that in order to relieve overcrowding means must be provided for taking the population into and out of London, not in one or two directions but in many directions, at rapid speed, frequent intervals, and cheap rates.”

To this recommendation of the Commission it should be added that means must be devised for preventing in “outer London” a repetition of those circumstances and conditions of life which, for more than half a century, entailed such sufferings and evils upon the people of London.

In reviewing the principal events, and studying the powerful underlying forces of the great movement of the sanitary evolution of London, the bitter experiences of the time gone by would indeed have been in vain if they did not point the way to an avoidance of past blunders and iniquities, and towards a better and happier future for the people. The lines upon which reform should move gradually become apparent as the events unroll themselves; and the measures now to be taken evolve and shape themselves from the successes and failures of the past.

The reforms just suggested are undoubtedly those which are most imperatively necessary. The whole experience of the past justifies the belief that they would soon work a great change for the better in the physical, mental, and moral conditions of life of large masses of the people of London. And from improved and healthier homes would come to the people increased comforts and happiness, and more physical energy and greater strength to fulfil the duties of their lives, and to meet whatever demands the future may make upon them and upon our nation.

The strength and even the existence of a nation depend upon the health of its masses. The stake at issue is a vital one to people and nation; and now more than ever is it necessary that the health and vigour of our race should be maintained at the highest possible attainable standard.