EVACUATION: THE RECEPTION
The first task of the receiving authorities was to find accomodation for the mothers and children before nightfall. The methods used to obtain billets vared from place to place and depended, to a large extent, on the preparations made beforehand. In some areas rehearsals had been held, billets selected, communications tested, local transport planned, food supplies arranged, talks given to householders on the care of children, while questions of education had been discussed between the billeting and the education authorities. In these instances, where the imagination and planning had marched together, the loca lworkers were better able to cope with the problems set by the arrival of groups of evacuees different from those expected. Over many parts of the country, however, reception arrangements had been incompletely organised. Not only have the inability of the Health and Transport Departments to guarantee the composition of the evacuated parties been a serious impediment to planning, but it had sometimes been ued as an excuse for inaction until the arrival of the evacuees was imminent.
The conferences which the county councils had been asked to convene several months before the war were chiefly preoccupied with transport arrangements. They did not stimulate much discussion on welfare. The Ministry of Helath representaztives who attended and addressed these conferences aroused little interest in the human side of the reception plans. As the Department had only four woem inspectors at the time, this may have contributed to the faiulure to foresee the conditions in which the mothers and children would arrive, and the kind of services they would require. The evacuating authorities too were not helpful; they either failed to volunteer information or else they sent reassuring statements. Some instances of lack of cooperation are given later.
In addition, however, to ehse reasons the ban imposed on advance expenditure by reception authorities generally explainedf, if it did not wholly justify the absence of adequate reception arrangements. It will be recalled1 that local authorities had been asking for months to be allowed to spend money on preparing maternity homes and hostels, and for the purchase of various utems of equipment. All these applications had been refused until six days before the outbreak of war. Local authorities then received permission to incur 'such reasonable expenditure as is necessary for the reception of evacuated
persons'.2 The operation of this ban during the period of evacuation planning from January 1939 onwards probably made some local authorities think that they need not take the matter very seriously, for surely a Government in earnest about evacuating 4,000,000 persons (including a large number of young children and expectant mothers) would allow reception authorities to make some preparations in advance?
When the order for evacuation was given by the Cabinet on 31st August there were, in the reception areas, no reception areas, no reception hostels or sick bays; maternity accomodation was quite inadequate in most places; none of the camps was ready; beds, blankets, crockery, blackout material, furniture, lighting, heating, cooking and many kinds of equipment and categories of staff were either insufficient or in the wrong places. Moreover, as was only to be expected, the standard—in quality and quanitity—of the social services in the rural areas was inferior to that in London and other big cities. Even so, there was at least one county authority which proceeded to curtail its maternity and child welfare activities in the belief that such things were unnecessary in wartime.
Many reports testify to the general confusion and unpreparedness which characterised the reception of the mothers and children in September 1939.3 All the troubles caused by lack of pre-knowledge about the evacuees, train delays, the ban on spending and other factors, were piled higher when many of the parties, travelling in crowded trains, sometimes without lavatories and adequate water supplies, arrived in a dirty and uncooperative state. It was not a good start. Town and country met each other in a critical mood.
The wartime guests of the country were further aggrieved when, in many areas, they were walked or paraded around while householders took their pick. 'Scenes reminiscent of a cross between an earlyRoman slave market and Selfridge's bargain basement ensued.'4 One boy likened it to 'a cattle show',5 for farmers picked strong-looking lads, and the presentable, nicely dressed children were quickly chosen. The method of billeting seems geenrally to have been either direct selection by householders or haphazard allotment. Mothers were not in demand, and there were many who gave advice similar to that received by Lady Stanley—'I hope you will be more lucky in your attempt to get soldiers' children than us. Don't
get a mother anyhow—it is that which has overset us'.6 The indiscriminate handing round of evacuees in the billeting of 1939 inevitably resulted in every conceivable kind of social and psychological misfit. Conservative and Labour supporters, Roman Catholics and Presbyterians, lonely spinsters and loud-mouthed, boisterous mothers, the rich and the poor, city-bred Jews and agricultural labourers, the lazy and the hard-working, the sensitive and the tough, were thrown into daily, intimate contact. The hardest group of all to billet were the mothers with several children. Such difficulties often occurred among Roman Catholic parties from Liverpool and Glasgow,7 for the mothers refused to be parted from their children. Attempts were made to install them in empty and unfurnished houses. Not infrequently they took the next train home.
It was some days before any authority knew how many evacuees had been received either in particular areas or in the country as a whole. While the last trainloads of evacuees were arriving, small groups of mothers and children were waiting on opposite platforms to return home and, in most areas, a great deal of reshuffling and redistribution was taking place. School units had been completely broek up and scattered over wide areas,8 particular groups had arrived in the wrong place or had temporarily got lost, expectant mothers and nursery parties had to be found, sorted out, accomodated afresh, and a host of difficulties had to be handled without delay. Emergency services of many kinds had to be hasilty improvised. Empty houses were requisitioned and adapted in a few hours for maternity cases; hostels, nurseries and sick bays were hurriedly organised, and country towns and villages were ransacked for medical equipment, furniture, beds, blankets, crockery and blakout material. Town clerks, directors and inspectors of education, medical officers, teachers, civil servants and volunary workers
scoured the market places and assumed the roles of carpenters, electricians and general handymen. Treasury edicts and departmental circulars were temporarily forgoten in the presence of sick children and mothers in a late stage of pregnancy.
The provision of maternity services for these mothers waw one of the most difficult and serious problems, although the number of expectant mothers electing to be evcuated was relatively small (12,300 in England and 405 in Scotland). Before the war, plans had been drawn up for sending the mothers out; but little had been done to provide for them in the reception areas. By July 1939, arrangements had been made for the transfer of about seventy-five percent of the midwives in London municipal and voluntary hospitals to casualty work, while two-thirds of the maternity beds in London had been earmarked for air raid casualties; but when the Ministry of Health inquired on 4th August if it might sancaiton expenditure on emergency maternity homes in the country the Treasurty was not very helpful. '… there is obviously a danger that enthusiasts will tend to magnify the need … not all expectant mothers will have babies in the first weeks of a war, and if a war should occur there should be time after the outbreak to make reasonable provision in most areas since I gather that nothing very elaborate is contemplated and makeshift arrangements would have to suffice in the early days.'9 There followed, during the first week or two of war, a desperate search for suitable buildings, equipment and midwives.
In the eastern region, which received some 1,900 expectant mothers, improvised accomodation included a unit of two beds in an occupied private house, four beds in a midwife's house, while such buildings as a farmhouse, a boys' club, and a disused block of a public assistance institution were hurriedly acquired and equipped. In setting up a maternity hom, the shortest time taken from the first inspection to readiness for use was five dazys. The kind of worh which had to be done to amek these buildings fit for use included the installation of bathrooms, lavatories, sinks, sluices and cooking facilities. In all, 100 units comprising 1,385 beds were provided in the eastern region during September and October 1939. Similar feats of improvisation were achieved in other parts of the country. A detailed account of these developments, which later grew into the emergency maternity scheme—one of the most successful wartime social services—are contained in Studies in the Social Services.
All this work of improvising a variety of services and of rebilleting mothers and children had to be carried on in an atmosphere which, from being friendly and compassionate at the start, rapidly deteriorated until, in some areas, it became openly hostile. It did so, partly
because of the complications and irritations that have already been described, partly because of bad manners and behaviour and for other reasons which will become apparent later, and partly because both parties had rarely met before and knew little about each other's way of life. But the absence of air attacks, and—in the West—the undramatic opening phase of the war, were perhaps the chief reasons for the rapid change in mood from sympathy to hostility.
The excitement and tension aroused at the end of August, the sense of momentous events, the dissemination of rumours and the distribution of gas masks; these were the things which made many people in country districts ready to cast themselves for the role of comforter and friend to the refugees who were expected to pour out of the cities. While the countrysie wsa thus preparing itself, the adulty refugees were giving reign to self-pity, getting tired and despondent on their journeys, and consoling themselves with thoughts of ease and comfort at the end. Both sides were, when they met, expecting too much. Disillusionment set in from the first day, and the local and national press were soon filled with protests from indignant householders. Instead if the expected stories of bravery and endurance under air attack, the newspapers (with less news than in peacetime to report) carried thousands of articles on the condition of the evacuees, while the post-bags of two ministers and many M.O.s were loaded with complaints of dirt, lousiness and immorality.
All the evidence that accumulated in the Health Departments led the Government ot change its policy on evacuation. That is one reason for studying closely the question of social conditions. Another is that, so far as the social services were concerned, evacuation dominated social policy for at least the first nine months of war. The debate on the condition of the people continued much longer, though on a quieter note. It was heard again—but in a minor key—when the second great migration took place in the autumn of 1940; it affected in various ways the development of certain welfare services, while the Education Act of 1944 and other legilsation bore witness to its deep influenece. At no time, however, was opinion so vividly, and so freely voiced, as in the autumn of 1939. The subject is therefore confined to this chapter, and will not be discussed in detail again.
The complaints that were made about the evacuees took various forms. It was said that the children's clothing was generally inadequate and, very often, in a filthy condition: that many of the mothers and chldren were dirty, verminous and affected with scavies, impetigo and other skin troubles: that a large proportion of the children wetted their beds and soiled their clothes, and that many mothers were feckless, irresponsible, ungrateful, and deplorably mannered. To what extent were these statements true? Did they apply to five percent, fifty percent, or one hundred percent of the
1,500,000 mothers and children? Sifting the evidence to answer this question was been a heavy task. Fortunately, a great deal of it may be discarded as merely repetitive, or obiously coloured by resentment, by the sharpness of what the anthropologists call 'culture-contact', or by the sudden consciouness of things neglected. Even so, the bulk of relevant material is formidable. In the present chapter, only a small part of it has been used for purposes of illustration.
As soon as the evacuation movement was complted the Health Departments began to receive a stream of appeals, resolutions and complaints about clothing and footwear conditions from local authorities, voluntary agencies, civil servants and private individuals ranging from Lord Derby to the wives of agricultural labourers. Newcastle reported that of 31,000 children registered for evacuation thirteen percent were deficient in footwear and twenty-one percent were deficient in clothing. In Manchester it was said that about twenty percent of the childern arrived for the evacuation rehearsals in plimsolls. A large number of Welsh local authorities who received evacuees from Liverpool spoke of 'children in rags', in a condition which 'baffles description', and of clothing which was so dirty and verminous that it had to be destroyed. Liverpool became known, in the early months of the war, as 'the plimsoll city'. 'It is all wrong', commented one report, 'tha a rich city like Liverpool should look to Welsh peasants and labourers to clothe and shoe its children'. Merseyside was not, however, the only target for criticism. Other areas were named in reports alleging that quantities of clothing had to be burnt, that no change of cloyhing had been brought by the children, that footwear was cheap and shoddy, and even that some children arrived sewn into a piece of calico with a coat on top and no other clothes at all.10
It is highly probable that most of the children were sent away in the best that their parents could provide. Apart from the question of pride—and the clothing of children plays an important role today in matters of social status—it is unlikely that the childern were sent to safety while their best clothes were kept at home. Much depends on the criterion by which the adequacy of a child's clothing id judged. It turns not only suych matters as town and country and summer and winter wear, but quality, durability and fit. The question of standards in relation to the economics of children's clothing was curiously neglected in all the social surveys of the nineteen-thirties. Little is known, for instances, about the number and cost of different sizes in shoes that a child needs during its years of rapid growth.11
Yet this appears to be one of the most burdensome items in a family budget, as the records of relieving officers and case-work agencies such as the Family Welfare Association amply testify. It is not wholly surprising, therefore, that full employment and regular incomes from about 1942 to the end of the war presented the Board of Trade with one of its most baffling problems—an immense, unsatisfied demand for children's shoes even though production increased.12
The wartime experience of the Board of Trade suggests that a large number of parents would have preferred, in 1939, to have sent their children away better equipped. They may be criticised for not doing so; but their failure may also serve as a reminder that evacuation followed a long period of widespread unemployment. During 1939 the average number of insured persons unemployed in the United Kingdom was 1,480,324, and there were 1,049,718 persons in receipt of poor relief in England and Wales. These figures did not represent a standard army of permanently poor, long-unemployed persons. The number who experience some spell of unemployment in a year was not generally known. But it was probably very considerable. If, therefore, the above figure is multiplied several times, and account is also taken of the dependants and relatives who shared in the consequences of this unemployment, then it may reasonably be assumed that a high proportion of the fathers of the evacuated children had experienced unemployment during 1937–9. This unemployment bore much more heavily on the cities than on the rural areas. One city alone, whcih was severely criticised for the condition of its children's clothing, spent over £5,000,000 on pulbic assistance during the three years preceding the war.13
It has been estimated that before the war there were about 4,000,000 families in Britain living from hand-to-mouth or from pay-day to pay-day.14 Of this number, one-half were continually in and out of debt. For all these families, the purchase of boots and clothing often meant a capital outlay beyond their immediate resources. Many of them therefore had to buy cheap and generally shoddy equipment. Besides a widespread useof pawnbrokers, secondhand dealers and jumble sales, there grew up, partly in response to demand and partly because the housewives were easy to exploit, a vast instalment purchase organisation—the clothing clubs of the poor.15 Apart, however, from the question of poor quality and high costs—got clothes bought by hire purchase were often expensive—these clubs and check traders represented an important material bond which tied
mother to their homes in the cities. They were therefore one in a multitude of influences which led many mothers to return home.
When all these factors are considered—the problem of capital outlay for clothes when income is low, irregular and insecure, the different needs of town and country life, the close relationaship between poverty and large families, and the complexities of varying social standards—it is not surprusing that the clothing of a considerable proportion of the evacuated children was found to be inadequate.16 The commonest complaints were that some of the children had no spare underclothing and nightclothes, that mackintoshes and overcoats were unknown to a proportion, that some boys were no underclothing at all and that boots and shows were generally defective. A typical report to the Ministry of Health stated: 'The town standard and requirements are much lower than that of the reception areas—especially in the small county towns—many Manchester and Liverpool little girls have never worn knickers, a fact that distresses and horrifies the foster-parents. A large percentage have never possessed sleeping suits, but take off the outer clothing and sleep in their underwear (the latter frequently being father's old shirt pinned and/or stitched to fits its new purpose). Few have ever possessed a "best" outfit'.
Shortly before the outbreak of war, the Ministry of Helath realised that something would have to be done to provide extrea clothing for children from very poor families.17 But it was thought that there would be only 'a relatively small number of necessitous cases'.18 The annual reports of those local authorities who, in the course of school inspections, classified the condition of children's clothing supported this belief; but the worship of the statistical average made the classifications meaningless. Thus, in 1938, the London County Council's school nurses found that the clothing and footwear of elementary schoolchildren was 54.6 percent good, 45.1 percent fair and 0.3 percent poot. A study of the returns for individual metropolitain boroughs discloses a very low proportion of 'good' ratings in certain areas, notably, Bethnal Green seven percent, Poplar thirteen percent and Stepney thirteen percent.19 These individual returns were not published.
Among other large cities, only Glasgow appears to have referred to the subject in its annual reports. In the last pre-war statements of the pbulic health department,20 it was reported that out of 46,325 children examined only fourteen had insufficient clothing, while thirty-five were 'ragged' and another thirty-five 'dirty'. In addition, twenty-two children had not footwear nad in sixty instances boots or shoes were judged to be in an unsatisfactory state. Although these assessments only applied to conditions considered inimical to health, they seem surprisingly few in number when compared with the reports on clothing from the areas to which Glasgow children were evacuated, and with the fact that the same department supplied boots or clothing, or both, to 32,842 children during the year ended July 1939. Moreover, when evacuation took place a month later, Glasgow education authority spent £6,500 alone on the provision of overcoats for evacuated children.
In Scotland, local education authorities had received statutory powers, as early as 19089, to provide boots and clotyhing for necessitous schoolchildren.21 But no such powers were given to local authorities in England and Wales. The Ministry of Health, conscious of the need to make some provision in the event of evacuation, approached the Treasury in the spring of 1939. But a request for 'a concelaed subvention' of £40,000 for any necessitous cases among some 2,000,000 children was turned wodn. 'On present evidence', it was said, there as no justification for spending Government money in this way, 'except inso far as the Board of Education giave a grant in respect of the material used in needlework lessons'.22 This grant was, howvever, very small and, moreover, sum of ½d. a week or thereabouts were recovered by some local authoritiesw from the children who wnated the garments they had made. The usual policy of most authorities was that needlework and cookery should pay their way, and they any outlay on materials should be recovered from sales. In practice, this meant in some poor areas that girls were not given material for needlework because they were not capable of making garments which could be sold. Ordinary domestic articles—such as aprons—could be sold only with great difficulty 'even at cost price'.
The Ministry of Health continued to press the case for a clothing grant and at the end of august 1939 assent was given. On the 25th, a confidential letter was sent to evacuating authorities authorising the purchase locally of boots and clothing up to a limit of £1 for every 200 children. A condition was attached to the grant: the use of Government money for thus purpose was not to be made known.
When evacuation took place the number of 'necessitous cases' proved to be exceptionally large.23 Much of the burden of cost therefore fell onto the shoulders of the foster-parents, who felt that it was not possible—or desirable—for two standards of dress to exist side by side under the same roof. This is precisely what had not been appreciated by the Health Departments. If the children were to be assimilated into their temporary homes then they would have to eat the same food and wear the same kind of clothes as the rest of the household. In many ways, evacuation spelt a compulsory levelling-up in standards. As neither the parents nor the Government had provided for this in a large number of cases, the foster-parents had to do so.
The result was an outburst of scrubbing, washing, mending and re-clothing in the reception areas. At their own expense, many foster-parents reequipped their guests. In addition, charitable schems were organised in a large number of districts to raise funds and receive gifts of clothing, the Minister of Health broadcast an appeal on 8th September (which produced a few thousand secondhand garments of varying quality), the National Union of Teachers voted £1,000 and many other voluntary gifts helped to ease the problem for a time.24 The contribution made by charity towards clothing the needy children of Britain did not end with the first evacuation. Gifts of clothing from America and other countries continued to arrive in large quantities, while the Maharajah of Gondal presented a lakh of rupees (£7,500) and other individuals and institutions gave financial help.
Eventually, however, it became evident that the problem was too large for charity. It was also, as the winter of 1939 approached, too urgent to be left to the piecemeal efforts of voluntary agencies. If the parents of a considerable children could not—or would not—provide adequate equipment then the Government could not leave the responsibility with the foster-parents.25 What then was to happen to the town children, with outworn shoes and flimsy clothing, who would have to spend the winter in the mud and wet of the country if the Government's evacuation policy was to be maintained? This question was typical of many which continually arose in the administration of the evacuation scheme. Nearly all of them threw up some threw up some issue of fundamental public importance. The Government
wanted the children to stay in the country, yet it did not want to do anything which might undermine parental responsibility. At the same time the Government itself had accepted certain responisibilities, and had given undertakings about the welfare of the children to both the parents and foster-parents. If the health of the children suffered through lack of clothing, the Government would not avoid criticism by blaming the parents.
The first step towards finding a solution to the problem was taken by the Ministry of Health in November 1939, when it issued a circular to local authorities on the provision of clothing and footwear.26 While emphasising the principle of parental responisibility, attention was drawn to the help available from the poor law, the unemployment assistance board and voluntary agencies, and the suggestion was made that in cases where the necessary provision could not be obtained from one or other of these sources, the matter should be reported by tyhe head teacher in the reception area to the director of education for the evacuating area. On the understanding that nothing was said in public, a sum of about £15,000 was distributed to directors of education to enable them to deal with 'necessitous cases'. This was, in effect, the beginning of a new social service. It arose from the shock experieneced by the country in September 1939 in discovering the condition of the clothing of a large number of children. Its further development is traced in later chapters.27
While the Ministry of Health had expected, from thewarnings given to it by local authorities, that a proportion of the children to be evacuated would be deficient in clothing and footwear, it had not foreseen the seriousness of the problem of enuresis. The term 'enuresis' means failure to control urination and is not synonymous with bed-wetting. The latter is generally applied to the habits of infants under the age of two to three years until they are trained to keep dry.
Although enuresis as a social and medical problem had been neglected before the war, nevertheless, there existed a good deal of scattered evidence regarding its incidence among the older children and adults. It was (and still is) an embaressing problem for the Army28 and the Navy, public schools, poor law homes, charitable institutions, Home Office approved schools, holidary camps, Ministry of Labour training centres and shipping companies.29 At the end of the First World War, the London County Council, for instance, in a report for the years 1915–19, referred to the trbouel caused by enuretics in
residential and camp schools.30 Again, in 1945, a study was made for the Council on the incidence in various schools and homes.31 It was found that the percentage of enuretics in the Council's residential schools and homes was:
In certified Roman Catholic schools the figures were higher in each age group, namely 27.5 percent, 18.4 percent and 8.4 percent.
These lessons were not heeded. The Health and Education Departments did not gather the available evidence, and the public were not told that just as the Navy might have trouble for a short while with a young lad joining a training ship or college, so foster-parents might expect some temporary enuretics among the unaccompanied schoolchildren. Nor did the medical profession (notably the psychiatrists who were much preoccupied at the time with the question of morale and bombing) help to prepare the lay public or the Government for what was certain to happen.
In May 1939 the Ministry of Health ordered mackintosh overlays for the young bed-wetters—estimated at sixty percent of the children under the age of five to be evacuated. But only a small number of these overlays had been delivered to local authorities by the outbreak of war. No provision was made for older children.
As soon as the children arrived in the country the trouble bega. 'Somewhat unexpectedly', remarked the Lancet, 'enuresishas proved to be one of the major menaces to the comfortable disposition of evacuated urban children … every morning every window is filled with bedding, hung out to air in the sunshine. The scene is cheerful, but the householders are depressed'.32 The estimates that were made of the frequency of the trouble during the first week ro two of evacuation ranged from about one percent to thirty-three percent at different ages from five to sixteen.33 The country was undoubtedly shocked: no other aspect of the social results of evaucation received so much pbulicity or lent itself so easily to exaggeration and misunderstanding.
It was misunderstood because hitherto it had not been discussed, and it was exagerrated, partly because it had not been expected, and
partly because it represented, along with all the other sacrifices involved in accepting strangers into the house, a burden on country people out of all proportion to the war effort then being made by the nation.
Enuresis, like other psychoneurotic symptoms, is an expression of mental protest.34 It is primarily a symptom of emotional disturbance, although in a few habitual cases it may be the result of acquired lesions, or of congenital abnormality of the urinary tract.35 Among a majority of the children who were troublesom in the first week or two of September 1939 it was caused by an acute sense of insecurity.36 The loss ostability and protection led these children to revert—temporarily—to irresponsible babyhood. The interruption of the relationship with the individual who had steered the child from helpless dirtiness to controlled behaviour caused the regression. Like other observers, Professor Burt, who noted a greate increase in incontinence, especially nocturnal enuresis, believed that the emotional effect of evacuation on the children had been underestimated.37 In most cases the trouble cleared up quickly, as the children settled down and got to know their foster-parents, the dark and silence of the countryside and their way to oudoor (and often primitive) lavatories.
In a minority of children the trouble was deep-seated. It was these cases which got mixed up with the majority of temporary ones, and gave so many evacuated children a bad name. Among the minority, there were some who were chronic enuretics; some who had never used toilet paper, and some who deliverately fould curtains and furniture and who used corners of a room for defaecation. 'No words can descrbie', said one report to the Ministry of Helath, 'the terrible state of the room. Every scrap of bedding, clothing and even the blinds and curtains had to be burnt immediately'.38 'You dirty thing, messing the lady's carpet', expostulated one Glasgow mother to her six-year-old child. 'Go and do it in the corner.'39
Some observers attributed these cases to faulty training, and to a deplorably low standard of cleanliness and behaviour in the parents.40 Many of the most undisciplined children appear to have come from the kind of broken home which produces, in Bowlby's words, 'affectionless thieves'.41 'What is true of enuresis', said another observer, 'is more dramatically so in the case of faecal incontinence. The child psychiatrist has long since ceased to regard faecal incontinenence as a symptom of great rarity, or indicating a severe regression, since it is met with sporadically in a large number of emotionally disturbed children. This has been quite clearly brought out by evacuation, where a number of children, many of them over five, and normally trained in clean habits, have shown this symptom. It seems likely that all cases are not due to an identical mechanism. In ordinary peacetime practice, a high proportion of these cases occur in step and foster children, suggesting an uncertainty in their emotional relationships. In other cases, the aggressive elements seem to predominate, the child using this as a final and desperate demonstration of anger or despair'.42
The state of things in broken homes, and in homes which had meant much emotional stress in early life and mother-child separation, produced children who were a constant source of trouble and expense, not only to the evacuation scheme and to those administering the social services, but, in later life, to their fellows in any group activity. An investigation of Army enuretics showed, for instance, that a large number came from such homes and revealed evidence of what the psychiatrists call 'love deprivation' in childhood.43
The great characteristic of man is his capacity to learn; but he can do little without training. And this the child does not get, during the all-important first five years of life, in the broken home; the home without stability or harmony. The children too become unstable, aggressive, lazy, cynical and untrustworthy. They are, in Paneth's words, 'hurt people'.44 'At home', wrote Paneth, 'they suffer from vermin, dirt and bad nourishment; from parents who have neither time nor patience for them, who often drink and always swear and of whom they are afraid; parents who represent their ideals, but ideals
in conflict with the rest of the world around them; parents whom they know are looked down upon and who are often prosecuted, cheating and being cheated. There the children live in an atmosphere which, though outspoken and tough in many ways, is secretive and untruthful on essential points'. It was some of the children from the cities who, although proportionately few in number, shocked the countryside in September 1939.
In other cases, among which Merseyside and Glasgow children figured prominently, the occurence of insanitary and anti-social behaviour was closely linked to the physical environment from which the children came. Slum mores are consistent with a slum home. Indeed, it is optimistic to expect anything else. When one broken-down water-closet has to be shared by anything up to thirty people,45 and there is no bath and no indoor supply of water; when there is incessant conflict between the need to keep order and the child's natural demand for space; when privacy is impossible and everyone's quarrels, love-making and sexual life are heard or witnessed by children, and when the day-to-day drudgery of the mother is accompaned by a trial of ulcerated legs, carious teeth, haemorrhoids and backache,46 the training of children in self-control and in the identification of truth becomes difficult—if not impossible.
Here, then, were many reasons to explain both the frequency and the cause of enuresis among a proportion of the million or so children who left the cities on the outbreak of war. The majority ofcases, which were largely due to emtional stress, cleared up quickly with sympathetic handling by foster-parents. Other cases, particularly some of the more complicated and difficult ones, were solved—so far as the evacuation scheme was concerned—by the return of the children to their homes.
The problem recurred in 1940 and after other evacuation movements during the war. But it never again aroused the same accusations and bitterness with which it was attended in 1939. For one thing, the Government abandoned, after the first attempt, the principle of mass evacuation; in the later periods of exodus, when place and time were planned in advance, most of the children were medically reviewed before they went away and more carefully billeted when they arrived. Secondly, the establishment of hostels in 1940 meant that enuretic
children could be removed from harassed or unsympathetic householders. Thirdly, and perhaps most important of all, the reception areas knew what to expect. During 1940–41 the Health Departments arragned a better distribution of mackintosh overlays to local authorities and, in addition, sanction was given for the payment of an extra allowance to some householders who were caring for children suffering from enuresis.47 These measures did not touch—nor were they designed to cope with—the core of difficult cases; but they prevented them from again becoming a source of public embaressment.
In addition to the complaints about clothing conditions and enuresis, protests were made in September 1939 that a large number of the children—and some of the mothers—were heavily infested with head lice. This accusation is worth examing closely, for not only are many of the published statistics slovenly in themselves, but chronic head infestation is often regarded as an index of general dirtiness.
Graphic descriptions of verminous conditions began to reach the Health Departments as soon as the mothers and children arrived in the country. 'There were scenes of horror in the village street.' 'The heads of some children could be seen crawling with vermin.' Commentaries of this kind were followed by reports of the number of infested mothers and children. No overall survey was made, btu many local inspections were carried out—too many to discuss in detail here48—and these showed that the experience of different districts varied greatly. In parts of Wales, and in districts of Cheshire, Herefordshire and Shropshire receiving evacuees from Merseyside, the proportion of infested children ranged between twenty-two to fifty percent. Areas receiving children from London were more fortunate, for the range of proportions was lower at about eight to thirty-five percent.49 In Scotland, reports from seventeen out of twenty-eight reception areas returned an average figure of thirty percent, though in many districts it was around fifty percent.
No generalisation from these scattered surveys can be applied to
all reception districts in the country. There were some local authorities, mainly in the south of England, who did not complain at all. There were others, like Atcham in Shropshire which received Catholic children from Bishop Goss school in Liverpool, and Wigtown county which took mothers and children from Glasgow, who survived a horrifying experience. In one part of Wigtown, which received a large number of mothers and children, conditions were so bad that the medical officer sent messengers out at once in all directions to but hair-clippers. With the aid of many helpers (including three detachments of v.a.d's) all heads were shorn. The thing was done without formality and without permission.
Evacuation came at the end of the summer holidays and the children had not, therefore, been under the eye of the school medical service for some weeks. Moreover, on the journey itself, the louse had many opportunities to pass from child to child, particularly as no medical examinations were carried out before the evacuees were sent away. This was unfortunate, in view of the reassuring statements that had been made publicly earlier in the year about the condition of the children. The Minister of Health had told the House of Commons in March 1939, '… these are not scrofolous and verminous children … they are the bud of the nation'.50
The Government did not consider the possibility of the children thoroughly examined before they went away. The expectation of what conditions would be like in the event of war was partly responsible for this. As Chapters I and II made clear, the detailed organisation of the evacatuion scheme was shaped by the kind of war that was expected. Inevitably, therefore, the consequences of a policy which placed all the emphasis on the speed of the exodus were experienced by the reception areas. The Government's defence was a good one: to search for lice and nits while bombs were falling would not have been possible. Nevertheless, an opportunity of inspecting the children was missed when evacuation rehearsals were held at the end of August.
Only a few of the reception authorities made arrangements for inspecting the children when they arrived. For some, conditions—such as the time of arrival—made the work impossible or else the staff were not available, while most authorities either did not know what to expect or else they assumed that the job had already been done. Neither the Health and Education Departments nor the evacuating authorities had warned the countryside of the troubles that
might arise. Liverpool, for instance, whose school medical service had been known to be inadequate,51 had informed some Welsh authorities that the children would arrive 'clean, under medical supervision and free from infectious disease'.52
Travelling conditions, and the fact that the exodus took place at the end of school holidays, probably led to an increase in the number of infested children. But the evidence of later surveys makes it doubtful whether the state of affairs before the war was greatly exaggerated in September 1939. Infestation is much more a family, than a school, disease, and its incidence in September 1939 reflected home conditions rather than school environment. Foster-mothers in reception areas did not full understand that many children living in bad home conditions cannot easily escape harbouring a few nits, and that if a child's head is left uncombed for some nights, infestation can rapidly become serious.
One result of the reports received by the Government in the early months of the war was that the Board of Education and the Ministry of Health arranged with Dr. Kenneth Mellanby to continue, on their behalf, investigations he had already begun into the incidence of head infestation. In March 1941 a note on Dr. Melolanby's work was sent to local authorities, who were urged to attack the problem.53 Their attention had previously been drawn to the need for intensive action when the Ministry of Health issued, in January 1940, a memorandum on methods of dealing with the louse, and on the powers already possessed by local authorities for preventing and curing the spread of head infestation.54
Although Mellanby's inquiry, which dealt mainly with the situation before the war, was to some extent biased as it was principally concerned with patients admitted to infectious disease hospitals, and therefore included a preponderance of poorer people, its results nevertheless broadly substantiated the reports from many of the reception areas. Mellanby found that about fifty percent of girsl under fourteen years of age living in industrial areas had lousy heads; that boys returned a lower rate, declining from forty-five percent at age two to twenty percent at age fourteen, and that pre-school children of both sexes had the highest rates of infestation—up to fifty-two percent. The percentage of children in rural areas found
infested was very low, while over the whole of the country body infestation was reported to be rare.
Mellanby repeated his inquiry during the years 1940–3.55 Despite the effects of bombing, shelter life, bad housing conditions and other wartime difficulties, some evidence was found of a slight decline in infestation among children. On the other hand, the percentage of girls aged fourteen to eighteen with lousy heads rose from approximately twenty-two percent in 1939 to around thirty percent in 1943. A high and increasing incidence of infestation among young women was also observed by the War Office. This was one of the results of an inquiry into the rate of infestat9ion among women entering A.T.S. training centres. It was found that during 1942–3 twenty percent of recruits were infested; that in 1944 and the first half of 1945 the proportion rose to approximately twenty-six percent, and that in different parts of the United Kingdom the figures varied very widely. Northern Ireland led the way with about sixty percent (or three out of every five girls), followed by Scotland (just over thirty percent), Western Command (twenty-three percent to twenty-nine percent), Northern Command (sixteen percent to twenty-six percent), while the Eastern, Southern and South-Eastern Commands came out best with a range of eight percent to sixteen percent.
It is time now to gather together this statistical material, and to consider one or two question swhich have been needing attention since this chapter on social conditions began. The first is: why did the evacuation reports shock the Government and public opinion? And the second:: what was the cause of these unexpectedly high rates of infestation?
Both these questions inevitably raise some big issues affecting the administration and work of the public social services. To understand why, it is necessary to look briefly at the pre-awr figures from the schools, and to compare them with the reports from the receptioon areas and with the other statistics quoted above.
To put the matter simply, what is required as evidence of the frequency of infestation before the war is the ratio between the number of individual children found with head infestation in a given year and the mean number of children attending school during the same period. The first figure—the number of children with infested heads—can only be obtained with accurancy as a result of unannounced inspections by school nurses. But this figure was not usually provided before the war either by the central departments or by the vast majority of local authorities.56 Instead, most authorities presented and
published the results of announced routine medical inspections,57 and in doing so related the number of infested children to the number of examinations carried out during the year. Or else the total of nurses' ascertainments during the year were given without any indication as to the number of individual children involved. The figures that were obtained and published on such bases as these were meaningless as well as misleading. This, Table VIII of the last pre-war report of the Board of education58 provided (a) the total number of examinations by nurses and (b) the number of individual children found unclean. Although the Board did not calculate a percentage, the unsuspecting reader might easily fall into the error of assuming that the two figures could be related to each other.
To discover the true incidence of head infestation among schoolchildren before 1939 was made even harder because of the use, by the Board of Education and other authorities, of the euphemistic 'found unclean'. This term crept into use many year before the war; it was part of a growing tendency in public life to avoid calling a spade a spade. Some local authorities found the ambiguity handy, for it enabled them to include in one figure not only head and body infestation but any condition of general bodily dirtiness. Other authorities did not so. But the figures of all authorities were, nevertheless, added together although they were sometimes composed of dissimilar elements. The results were then publicy presented by the Board of Education in the form already described.
In their annual reports on the work of the school medical service the London County Council (and many other authorities) gave prominence to the results of the routine inspections. Thus, in 1938, under the heading of 'cleanliness', the Council announced that 97.7 percent of children were found free of nits or pediculi in the hair.59 Although they were available, the Council did not publish the statistics for the individual metropolitain boroughs. These showed a range—even for routine inspections—of from 0.2 percent in Lambeth and Hampstead to 18.6 percent in Shoreditch.60 Likewise, Liverpool gave no figures for individual areas when reported that 4.5 percent of boys and 13.1 percent of girls were found unclean at
routine inspections.61 Lower figures were reported from Glasgow, where only 0.6 percent of boys and 9.5 percent of girls were found with nits or lice in their heads at routine inspections.62
Such figures as these cannot be reconciled with the results of Mellanby's inquiries or the reports from the evacuation areas. Without exceptoin, so far as the writer is aware, the reports of local authorities for the large cities underestimated the incidence and drew a self-satisfied and optimistic picture. Mellanby reached the same conclusion. He also observed that whereas he had found no deterioration among children during the first four years of war, the published reports of many school medical officers showed higher figures of head infestation/63 It was thus erroneously assumed by many people that children had become lousier because of lack of parental control, the absence of mothers on war-work and other factors, whereas the likely explanation was that ascertainment had improved as a result of the lessons of evacuation in 1939.
The contradictions between the official facts that were published before the war and the evidence on social conditions that came to lights in September 1939 and subsequently were not confined to the matter of head infestation. The cheerful prominence given to the report that only about two percent of the men called up under the Military Training Act in 1939 were unfit for services was later found (and admitted) by the Government to have been unwarranted.64 In this matter, as in many others, everything depended on the quality of the medical exmination and the criteria adopted to determine fitness for service or for anything else. If these things were not stated and discussed, the figures by themselves not only meant very little but were also dangerous, inasmuch as their dissemination opened the way to complacency and their continued used deadened criticism.
That these understandable influences could infiltrate and affect the work of local authorities was particularly true of the assessment of the nutritional state of schoolchildren. 'Cheerfulness is a cardinal virtue', remarked one observer, 'but an unreasonable optimism is the most damning, as it is the commonest fault in a nutrition return'. This was the comment of a medical officer of the Board of Education who, in analysing these returns for 1939, found that no less than seventy-two local authorities did not report a single child as having been classed as having undernourished.65
When the returns for individual towns are compared with the reports from the reception areas on the frequency of lousiness, scabies and other skin diseases among the children from these towns, it becomes clear that optimism (if that is the world to use) had bitten deep. The disparities between what Liverpool said about its children, and what other people said about the, have already been remarked. To this may be added the conclusion of the Board of Education's medical officer that the Liverpool returns on the nutritional state of its children 'show an optimism which is frankly incredible'.
One further reason, which helps to exaplin why public opinion was shocked by the experiences of evacuation in 1939, was the absence, for some years before the war, of adequate public information by central and local authorities about their activities in the field of the social services. Statistical intelligence and annual reports on work done had still not recovered from the curtailment of published facts in 1915, in the early nineteen-twenties and again in 1931. How serious this was can be demonstrated by a simple sum. Despite retrenchment in 1915, caused by financial economies and staff shortages, the five annual reports of the Chief Medical Officer of the Board of Education during 1915–19 totaled 1,164 pages, whereas during 1934–8 inclusive the corresponding reports were no longer than 651 pages in all.66 Quanity is not, of course, a good index of value, but a critical survey of the content and spirit of the ten reports does not lead to any higher appreciation of these public documents for the pre-war years.
The deterioration in the standard and output of social facts partly explains why it was that many people were ignorant of the conditions of life in a large number of town-dwellers. It was these conditions, the insanitary homes,67 the lack of baths and lavatories,68 the crowded
rooms and congested streets which, along with poverty, helped to generate the dirt, fashion the behaviour, and dull the mind of a people long inured to drudgery and disease yet, withal, resistant to any force which threatened the solidarity of the family circle.
Many people realised the folly of balming the children; but most were unsparing in their criticism of the adult evacuees. This too was often thoughtless. Corrupt manners naturally provoke censure, but they are usually the product of a corrupting environment. Such an environment signifies slovenliness and dirt, bad language69 and moral delinquency. Broken homes and undisciplined days reflect uneasy levels of livings. Garish lights and noise, decrepit public houses,70 pin-table saloones, fun-fairs, chain cinemas and fish-and-chip shops are the natural acccessories to such a culture. Trees and woods, country lanes and quiet fields are not. An environment which produces a higher infant mortality rate than Tokyo does not generally rear children who can come to terms with life in an Ayrshire village.71
This brief incursion into the condition-of-the-people question has concentrated chiefly on three problems: clothing deficiencies, enuresis and head infestation. The study that has been made of these problems does not pretend to be comprehensive, nor must it be assumed that they cover the whole range of questions which arose from the first evacuation. They were selceted, and they are put forward, not as exhaustive accounts of social conditions, but as illustrations of a particularly important episode in social history of the war. To have added a discussion of other questions such as the feeding and sleeping habits of evacuated mothers and children in relation to the standards of other social groups, would have made this chapter disproportionately long.
Nor can much be said here, for no adequate records exist, of what the househgolders and the local authorities in the reception areas did, during the first few weeks of September 1939, to cope with these problems. Although services were quickly improvised to deal with the most troublesome skin diseases and other ailments and to delouse the infested mothers and children, the major burden of cleansing children, cutting their hair and re-clothing them, was shouldered by the foster-parents. The contribution made by all these unnamed householders to the welfare of evacuated children, and the growth of new forms of social care in the reception areas, are examined in later chapters.
Because the shock to public opinion over the condition of some of the evacuees rivalled the outcry after the Boer War with its disclosures of sickness and low physical standards, it should not be assumed that all the evacuated mothers and children had been lving in squalor reiminscent of the eighteen-nineties. Nor did the presense of lice or nits in the hair necessairly mean that bodies were dirty, homes filthy or parents feckless.72 Had there been so much parental neglect, it is unlikely that eighty to ninety percent of London parents and seventy-four percent of Glasgow parents would have taken the trouble to attend during the school medical inspection of their children before the war.
If the revelations of evacuation are to be seen in the right perspective, and not simply against the unfavourable background of the early, unexpectedly quiet, months of war, it will be helpful to make one final point before this chapter ends. It is one which, in all the book and all the controversy which accompanied and followed the first evacuation, was never mentioned.
Practically all the mothers who went to the reception areas in September 1939 had spent part of their childhood and youth during the war years of 1914–18. For many, it was not well spent. 'There has been', said one report of 1917, 'a great increase in the wage-earning employment of children out of school hours'.73 Young children were employed for thirty to forty hours in addition to their schooling. Another report of 1917 emphasissed the 'premature and abnormal curtialment of school life for a large number of other children'.74 By 1918 it was estimated that the war had imposed a reduction of over one-third on the medical inspections of schoolchildren.75 Doctors and nurses had more imperative tasks to perform. Such drastic reductions in the work of the school medical service were not made without misgivings, for a survey in 1917 of school-leavers showed that seven to ten percent were absent from school on grounds of more or less chronic ill-health, and twenty-one percent were suffering from serious defects which 'will pervent them from playing their fair and proper part as citizens'.76
It was not only education and medical aid which many of the children missed during these war years. At a critical period of their lives they had missed their fathers and, in many homes, their mothers. An inquiry into the parental condition of 400 juvenile offenders showed that in a high proportion of homes the father was serving in the Army or Navy.77 Nor did the irremediable effects of the First World War end with the Armistice. There were over 750,000 war dead and as late as 1930, some 1,664,000 war disabled.78 How many lives were harmed in childhood and adolesence by the death of disablement of fathers? These children also suffered, as some children will always suffer, from economic inequalities, and from failure on the part of society to distribute fairly goods and services in short supply. Throughout the First World War there were never less than one-quarter of a millon children on poor relief in England and Wales.79
The Chief Medical Office of the Board of Education in drawing attention–as early as 1916—to the premature employment of 'a very large number' of young children, asked a question which is of particular importance in summing up this chatper. He first said that physical injuries in childhood are often insidious and inconspicuous. They do not catch the eye, or arrest the observer, but they may undermine the growth of the child at a critical point in its life. He
then asked: what will be the condition of these children in five, ten or twenty years?80
The long-term consequences of modern war cannot be disclaimed or disparaged just because they are not easily and quickly apparent. The bills of war contain both tangiable and intangiable items; when the first have ben paid, the second may still be accumlating. The social accounts of the First World War were not audited or inspected, partly because they were not obviosuly susceptible to measurement, and partly because they were obscured at the time by the distractions of balance sheets of a material kind.
It is well that these things should be recalled if any judgement is to be passed on the pattern of town life which was exposed in September 1939. Nor must it be forgotten that the evacuate dpopulation was, to a large extent, slsected by its inability to arrange—or but—safety in the country as 2,000,000 other people had done. All the spotlights were trinaed on those who travelled under the Government's scheme; nothing was said of those who remained behind or of the 2,000,000 who evacuated independently. The behaviour of some of these unofficial evacuees, who were not all aged and infirm, may have been as anti-social—in different ways—as that if the dirty and feckless mothers from the slums. The Times observed: 'The hotels are fillied with well-to-do refugees, who too often have fled from notyhing. They sit and read and knit and eat and drink, and get no nearer the war than the news they read in the newspapers …'81
At the other end of the social scale, large numbers of children—five percent in some areas and fifty percent in others—and a proportion of mothers had lousy heads. But it did not follow that itwas just to stigmatise them all as 'problem families'. Perhaps two percent, perhaps five percent, were 'problem' children from 'problem' homes. They were undoubtedly lousy, as well as generally dirty, and their behaviour reflected the community's failure before the war to cope with the condition of this particular group in society. The remaining ninety-five percent or ninety-eight percent, or whatever the figure may be, were not the neglected children of irresponsible parents. Their clothes may have been inadequate for country were, they may have preferred chips to green vegetables, they may have suffered from skin troubles and they may have had dirty heads, but such things do not mean that they beloned to the 'social proble' group. The facts do not sustain more than that. But just as it is necessary to distinguish between infested heads and bodily squalor, so it was silly for some M.P.s to protest violently at any mention of lice. In the post-mortem debate in the House of Commons some M.P.s
attacked other for casting slurs on 'the working-class'.82 Such emotional protests were not helpful. The decencies of health and sanitation are moreeasily achieved by the rich than the poor, but they are no sufficient measure of personal virtue or political principle. The louse is not a political creature; it cannot distinguish between the salt of the earth and the scum of the earth.
Contents * Previous Chapter (VII) * Next Chapter (IX)
1 See Chapter V, pp. 91–2.
2 Ministry of Health circular G.E.S.10, 25th August 1939.
3 Ministry of Health regional office reports; local authority reports and letters to the Ministry of Health and the Department of Health for Scotland; Boyd, W., (edited by) Evacuation in Scotland, 1944; Padley, R., and Cole, M., Evacuation Survey, 1940, and memorandum 'Evacuation 1939' prepared by the Charity Organisation Society for the War History.
4 Monograph by G. M. Lindsay, deputy evacuation officer to the West Hartlepool local education authority, 'The Physical, Social and Education Effects of Evacuation upon West Hartlepool Evacuated Schoolchildren', 1942.
5 Boyd, W., (edited by) Evacuation in Scotland, 1944.
6 This was written in connection with the activites of the Patriotic Fund of the Crimean War period. It was part of a voluntary scheme whereby the wives and relations of officers gave help to soldiers' families (Mitford, N. (edited by), The Ladies of Alderly, 1938).
7 In the Roman Catholic families evacuated from Clydebank, fifty-six percent had four or more children. (Boyd, W., (edited by) Evacuation in Scotland, 1944).
8 'May a school party was discoved to be dispersed in half-a-dozen to a dozen village scattered over many miles of countryside. "One headmaster", wrote a correspondent to The Times Educational Supplmenent, "has about 100 children billeted in six small village in the south of the county, while 70 more are in a county town 20 miles to the north". One half of a girls' senior school was spread over thirteen villages. Such cases were frequent—one had almost said typical.' (Dent, H. C., Education in Transit, 1944.) A mass of reports to the Board of Education and to local education authorities gave similar instances of the breakdown of school organisation and the loss of identity of evacuated schools. The chief inspector to the London County Council, in reviewing these educational problems in a report in December 1939, quoted many examples; thus, one London school in Norfolk was spred out in villages over an areas of about 400 square miles, and anoter was distributed over no less than 23 villages. The effect of all this disorganisation, central to a study of the educational system during the war, is the concern of Dr. Weitzman's educational volume in this series of histories. [Weitzman's volume was never published]
9 Letter from Treasury to the Ministry of Health, 8th August 1939.
10 See, for instance, Women's Group on Public Welfare, Our Towns, 1943.
11 In this connection it is interesting to note that a new national cost of living index, introduced in June 1947, allows for more expenditure by working-class families on wines and spirits (excluding beer) than on children's shoes, (Industrial Relations Handbook 1944, Suppl. No. 2, 1948).
12 For details see Chapter XX.
13 Report of the Public Assistance Committee, Liverpool, 1939.
14 Hilton, J, Rich Man, Poor Man, 1944.
15 Exact data on the ramifications and turnover of clotuhing clubs and check traders are not available. These institutions have not been studied by economists or sociologists. For a general description of the methods employed by the clubs, see Our Towns, (1943), pp. 54–65 and 124–6.
16 Further information on the matter of familiy economics is available from the results of an analysis of the recovery of billeting charges from the parents of evacuated schoolchildren—see Chapter X, pp. 159–61.
17 Ministry of Health Memo. E.V.4, July 1939. The proposal to supply clothing only applied to unaccompanied children. Children evacuated with their mothers were excluded. Families on public assitance and unemployment pay were eligible to apply for help. The Ministry of Health hoped that the needs of others would be met by charitable agencies.
18 Ministry of Health circular 1871, 12th September 1939.
19 These figuires were supplied to the historian by the Public Health Department of the London County Council.
20 Education Health Service Report for year ended 31st July 1939.
21 Section 6 of the Education (Scotland) Act, 1908.
22 Letters from the Treasury to the Ministry of Health, 2nd May 1939 and 28th July 1939.
23 Liverpool, allowed £502, spent £2,715—a sum approved by the Regional Commissioner.
24 A few evacuating authorities had attempted before the war to organise charitable schemes. In London a press appeal was made in July 1939, and gifts of clothing were distributed among the poorer schools.
25 It was repeatedly stated by the Ministry of Health that billeting allowances did not include the cost of clothing or footwear, '… no obligation is imposed on the householder to remedy deficiencies of this kind'. (Ministry of Health Memo. E.V.4, July 1939.)
26 Ministry of Health circular 1907, 7th November 1939.
27 Chapter X, pp. 165–6 and Chapter XIX.
28 See, for example: 'Investigation and Treatment of Enuresis in the Army.' Backus, P.L. and Mansell, G. S., British Medical Journal, 7th October 1944, ii, 462.
29 Women's Group on Public Welfare, Our Towns, 1943.
30 London County Council Annual Report, 1915–19. Vol. III, p. 95.
31 London County Council memorandum, 'Enuresis in Residential Schools', 28th November 1934, supplied to the writer for the purposes of this narrative.
32 Leader on the Lancet, 7th October 1939, ii, 794.
33 A figure of four to five percent was report from Brighton (Gill, S. E., British Medical Journal, 10th August 1940, ii, 199) and Boyd tabulated various Scottish figures ranging up to thirty-three percent (Boyd, W., (edited by) Evacuation in Scotland, 1944). Many reports to the Ministry of Health spoke of 'very large numbers' or cited figures between ten and twenty percent.
34 It is a significant fact that the Care of Children Committee (the Curtis Committee), appointed by the Governmnet in 1945 to inquire into the provision for children deprived of a normal home life, found that enresis was one of the most frequent complaints in voluntary and public assistance homes. One matron of a local authority home said that when children were ill they did not wet their beds, and she thought this was because they were getting the extra attention they needed. In many homes, however, the trouble seems to have been made worse by bad treatment and a system of punishments. In a number of charitable homes the enuretic children were distinguished from the rest in their sleeping arrangements, and in one such home they had a red light by their beds, (Report of the Care of Children Committee, Cmd. 6922, 1946, pp. 66–7 and 84–5).
35 Annotation in the Lancet, 9th June 1945, i, 728.
36 In a proportion of the sodlers evacuated from Dunkirk in 1940, enuresis was noted as a response to feelings of stress and insecurity. (Anderson, C., Jeffrey, M. and Pai, M. N., Lancet, 12th August 1944, ii, 218.)
37 Burt, C., British Journal of Educational Psychology, 1940, x, 8–15, and Burt, C. and Simmins, C. .A., British Journal of Educational Psychology, 1942, xii, 71–5.
38 Billeting officer's report to Lleyn Rural District Counil, 8th September 1939.
39 Report by medical officer of helath of the Stewarty of Kirkcudbright.
40 F. D. M. Livingstone emphasised the influence of past mismangement (The Practitioner, March 1940); J. Fergueson considered that in a large number of children enuresis was the result of bad training (Proceedings Royal Society of Medicine, May 1940); R. C. Webster referred to the admissions by older children or parents that enuresis was of long standing (Public Health, November 1939); and D. M. Odlum laid stress on the importance of training in habits of cleanliness infancy and early childhood (British Medical Journal, 6th January 1940).
41 Bowlby, J., Int. J. Psycho-anal., (1944), xxv, 1.
42 Creak, E. M., Proceedings Royal Society of Medicine, vol XXXIII, no. 7, May 1940.
43 Backus, P. L., and Mansell, G. S., British Medical Journal, 7th October 1944, ii, 462.
44 Paneth, M., Branch Street: A Sociological Study, 1944.
45 An enquiry into the lives of children in Shoreditch showed that about one-quarter had an indoor closet, while in over half the cases the closet was shared by a number of other individuals ranging from about eight to thirty. One-third had no indoor water supply, sixty-eight percent had no facilities for bathing at home, and in fifteen percent of the cases available supply of water was shared by three of more families (Shoreditch Housing Association, Growing Up in Shoreditch, 1938). Further details about the lack of baths, lavatories and water supplies in London and other cities and areas of England and Scotland are given on p. 131–2.
46 For a general description of these conditions see Spring-Rice, M. Working-Class Wives, 1939. For some figures on the high incidence of, for example, varicose veins see Foote, R. R., Lancet, 1947, i, 84.
47 The Provisional National Council for Mental Health first suggested the payment of additional allowances, and the Ministry of Health, with some misgivings agreed in June 1940. The fears expressed by the Department were substantiated in one case, where an extra 3s. 6d. a week was authorised on October 1940 for a householder in a Welsh rural area. This soon became known in the district. Although a doctor's certificate had to be obtained as evidence that the child was suffering from enuresis, the sum of about £350 was paid out to the villagers by the local council for th year ended 31st March 1942, notwithstanding a considerable reduction in the number of billeted children.
48 The conclusions of some of these surveys were published, e.g. Public Health, November 1939, no. 2, vol. LIII, and others were referred to in the annual reports for 1939 of medical officers. The results quoted here have been taken from these sources and from departmental files.
49 A survey made by the National Federation of Women's Institues showed a range of four to forty-five percent among children evacuated from the metropolitain boroughs.
50 H. of C. Deb., 2nd March 1939, vol. 344, col. 1524. The Ministry, in its 'Suggestions for Authorised Visitors' (circular E.V.2, 5th January 1939), had stated: 'Any householder who raises a question as to the cleanliness of the children may be assured that schoolchildren are subject to regular medical inspection, that there is no greater danger of dirt or infection from these children than from any other representative group in the country, and that the best possible arrangements will be made for their medical supervision'.
51 The service was inspected by the Board of Education in December 1939 when the arrangements for ascertaining verminous children were found to be inadequate. No further inspections were made before the war.
52 For instance, at a conference with Caernarvonshire County Council on 8th May 1939.
53 Ministry of Health circular 2306 and Board of Education circular 1544, 17th March 1941. A full report of the inquiry was published in the Medical Officer, 1st February 1941, i, 39.
54 Ministry of Helath Memo. 230/Med., January 1940.
55 Medical Officer, 25th December 1943, ii, 205.
56 As examples of the difficulty of understanding the statistics of head infestation among boys and girls attending elementary schools, see the figures given in the Annual Reports for 1938 by Liverpool and Manchester on the school medical service.
57 Announced inspections meant that the parents had an opportunity to clean the children before they were seen. In the majority of schools about six minutes were allowed for the inspection of each child. The form that had to be completed generally asked about 24 questions, head infestations being only one item. In practice, however, these 'medical' inspections appear to have occupied only one or two minutes per child in most cases (see Mellanby, K., Medical Officer, 1st February 1941, i, 39).
58 The Health of the School Child, 1938, p. 64.
59 Report of the School Medical Officer, 1938, p. 9.
60 These figures were supplied to the historian by the Public Health Department of the London County Council.
61 Report of the School Medical Officer, 1938.
62 Education Health Service Report for year ended 31st July 1939.
63 Mellanby, K., Medical Officer, 25th December 1943, ii, 205. See also appendix of Our Towns (Women's Group on Public Welfare, 1943), which contains the only thorough analysis know to the writer of the statistical problems involved in calculating rates of head infestation.
64 Army Appropriation Account, 1939 (para. 15, 'Acceptances for Army Service of Unfit Men') H.M.S.O., 1941.
65 Including the authorities for such areas as Ebbw Vale, Aberdare, Bradford and Doncaster.
66 During 1939–45 no reports at all were published.
67 In London, refuse had to be carried through sixty-three percent of all houses (and often through living rooms as well), (Statement of the President of the Institue of Public Cleansing, Public Health, October 1943, vol. LVII, 2).
68 No comprehensive national records exist to show the proportion of urban houses before the war which were without baths, piped water supplies and indoor lavatories. The Ministry of Health even lacked complete information about the number of public baths and wash-houses.1 Various surveys and inquiries instituted after 1939 provide sufficient data to show, however, that the number of inadequately equipped houses in urban areas was much higher than was generally recognised (some facts on conditions in rural areas are given in Chapter X, p. 177). In Hull, forty percent of the houses were without baths in 1943.2 In Bootle, the proportion was the same for 1939.3 In York, about sixty-six percent of working class houses were without baths in 1939.4 In Stepney, ninety percent of families had no bathroom in 1939.5 In Salford, fifty-two percent of the houses were without baths in 1943, and sixty-six percent had no proper food store.6 About one-half of the population of Glasgow had no baths in 1944, and one-third had to share lavatory accomodation with anything up to six families.7 One-third of all houses in the burghs and cities of Scotland had no independent water-closet in 1944.8 Water-closets or earth-closets had to be shared in common by the people lving in 405,000 out of the 1,319,570 dwelling houses in Scotland in 1946.9 In Birmingham, nearly one-quarter of the city's 283,611 dwellings had no bathroom in 1946, nearly one-third had nobath, twelve percent had no separate lavatory accomodation, two percent had no internal water supply and ten percent were 'back-to-back' houses.10 A national inquiry by the British Institue of Public Opinion in 1944 showed that fourteen percent of the poorer classes had no indoor sanitation.11 An investigation carried out by the Social Survey for the Ministry of Works in March 1947 showed that thirteen percent of households in urban areas of Britain had no baths and a further twenty-niine percent had only portable baths. In London, the proportions were fourteen percent and twenty-two percent respectively, and in urban areas of Scotland, eighteen percent and thirty-five percent respectively. In the poorest of five economic groups in urban areas of Britain, twenty-nine percent had no baths, and a further forty-one percent had only portable baths. The respective proportions and in the highest economic group were one percent and three percent. Approximately fifty-four percent of the poorest group could only obtain hot water for washing clothes by using kettles and pans on stoves. about three percent of all households in urban areas of Britain had no piped water supply.
1 H. of C. Deb., 9th March 1944, vol. 397, col. 2183, and 10th May 1944, vol. 399, cols 1930–1.
2 Hull Regional Survey, Civic Diagnosis, 1943.
3 Letter from the Town Clerk of Bootle to the writer, 29th April 1947.
4 Rowntree, Seebohm, Poverty and Progress, 1941.
5 Stepney Reconstruction Group, Living in Stepney, 1945.
6 Blease, J. E., Journal of the Royal Sanitary Institue, January 1946.
7 H. of C. Deb., 8th March 1944, vol. 397, col. 2094.
8 Scottish Housing Advisory Committee, Planning our New Homes, 1944.
9 Scottish Housing Advisory Committee, Modernising our Homes, 1947.
10 Birmingham Public Health Department, Report by the Medical Officer of Health on the Housing Survey, 1946.
11 News Chronicle, 9th November 1944 and 24th January 1945.
69 A story which is related in Our Towns (Women's Group on Public Welfare, 1943) shows that swearing often begins at a very early age. A child of some three years with a dummy in her mouth, was seen sitting in a field of stripping hops. She ran short of hops, removed the dummy, gave a piercing yell of 'More bleedin', bloody 'ops' and put the dummy back again.
70 Some of the evacuees, who caused much distress in the reception areas, came from a particular district in Liverpool where public houses can be found on the average every 50 yards or less (Jones, D. C., Survey of Merseyside, 1934).
71 Glasgow, with infant death rates of 98, 99, 109 and 104 per 1,000 births in 1934–7. The corresponding rates for Tokyo were 120, 88, 90 and 86 (League of Nations, Annual Epidemiological Report for 1937).
72 'The abundance of the head louse among the schoolchildren in cities in Britain and its rarity in adults is remarkable. I cannot put that down to negligent schoolchildren or negligent mothers. I suggest that there may be some difference in resistance to the parasite, a resistance that increase as the host grows older.' (Buxton, P. A., Proceedings of Royal Society of Medicine, 16h January 1941, vol. XXXIV (1), 193).
73 Annual Report of the Chief Medical Officer of the Board of Education, 1917.
74 Annual Report of the Chief Medical Officer of the Board of Education, 1917.
75 Annual Report of the Chief Medical Officer of the Board of Education, 1918.
76 Annual Report of the Chief Medical Officer of the Board of Education, 1917.
77 Leeson, C., The Child and the War, 1917.
78 Approximately forty percent of all the men wh oserved in the Forces were either killed or disabled (Official History of the Great War, Medical Services, Statistics volume, 19031, p. 315).
79 Return of Persons in Receipt of Poor Law Relief, 15th December 1919.
80 Annual Report of the Chief Medical Officer of the Board of Education, 1916.
81 10th January 1941.
82 H. of C. Deb., 14th September 1939, vol. 351.