On 24 November 1918, Prime Minister David Lloyd George gave a speech in Wolverhampton. The Armistice two weeks earlier meant he was ‘the man who won the war’. Yet still, he told them: ‘the work is not over yet – the work of the nation, the work of the people, the work of those who have sacrificed. Let us work together first’. He continued:
“What is our task? To make Britain a fit country for heroes to live in. I am not using the word ‘heroes’ in any spirit of boastfulness, but in the spirit of humble recognition of fact. I cannot think what these men have gone through. I have been there at the door of the furnace and witnessed it, but that is not being in it, and I saw them march into the furnace. There are millions of men who will come back. Let us make this a land fit for such men to live in. There is no time to lose. I want us to take advantage of this new spirit. Don’t let us waste this victory merely in ringing joybells.”
These words were important. Not only because they constituted a promise – from the Prime Minister to those who were returning from the horrors of the war and in the memory of those who would not return. But also because this promise was in many respects the foundation stone of the Lloyd George coalition as it went to the polls, barely a month after the end of the war. A coalition between a radical Liberal PM and the Conservative Party (amongst others) had been understandable during the war. All sides were committed to refocusing the war effort and saw a greater role for the state in doing so. Conscription, for example, Lloyd George and his coalition allies were readier to consider than many Liberals. But what was their common purpose in peacetime?
Whether or not Lloyd George genuinely sought a permanent realignment in British politics by continuing his coalition beyond the war, in the short term he certainly needed it to embody a broader sense of national unity. In speeches such as this, he was laying claim to the notion that this shared spirit was one of reform. As Chancellor of the Exchequer he’d used pensions and national insurance to commit the British state for the first time to directly addressing the poverty caused by old age and sickness. Now, as Prime Minister, and he had no intention of relinquishing his reforming zeal.
Yet, by the time he left office in 1922, it had amounted to little. Nowhere was this more obvious than in the case of housing, as Kenneth (now Labour life peer Lord) Morgan explained in his history of Lloyd George’s postwar coalition. After six months of the house-building programme there was a shocking gulf between calls for half a million new homes and the 10,000 under construction, let alone the 180 actually occupied. The final figure of 170,000 was nowhere near the scale widely agreed as necessary, and certainly a long way short of the hopes roused by Lloyd George’s stirring rhetoric.
Explaining what Philip Abrams, in his influential 1960s Past and Present article, dubbed ‘the failure of social reform’ has been a long-running exercise for political historians. Was it inevitable that a Conservative-dominated government would recoil from any extensive plans for social reform? Did the wave of businessmen elected to the Tory benches in 1918 shift the centre of gravity in the party away from accommodation with Lloyd George? Was the Prime Minister himself more interested in foreign affairs or simply remaining in office at any cost? Were any ambitions for major reform hopeless in the economic circumstances of the early 1920s?
These are bigger questions than can be answered in a blog post. But I would like to briefly consider something that suggests Lloyd George’s ambitions, at least, were genuine. And that is who he appointed to key positions. During the war his social reconstruction committee had brought together the social investigator Joseph Rowntree and the Fabian Beatrice Webb with the former Conservative Prime Minister and former president of the Garden Cities and Town Planning Association Lord Salisbury. This was perhaps indicative of what Lloyd George attempted to do in all areas of government, bringing together figures from across the political spectrum who might share his willingness to think big.
And the same can be said after the war of the three key appointments to the newly-established Ministry of Health, responsible not only for medical services but also housing as part of a broader understanding of ‘health’. This made it the government department essentially charged with delivering on the Prime Minister’s promise of homes fit for heroes.
Christopher Addison, 1869-1951
The UK’s first Minister of Health was a medical man of some repute. Before entering politics his method for thoracoabdominal topography (locating the pancreas) had become known as “Addison’s clinical plane”. He’d been appointed Professor of Anatomy at University College Sheffield and gave the prestigious Hunterian lectures for the Royal College of Surgeons in 1901. His doctoring in some of the poorest areas of East London and beyond brought him a deep insight into the most crushing poverty of the earliest days of the twentieth century and this motivated his move into elected politics.
In 1910 the forty year-old Addison was elected Liberal MP for Hoxton, soon finding himself in the middle of the fierce debates over Lloyd George’s health insurance plans. In their sympathetic biography, Jane and Ken Morgan credited him with making the national insurance bill passable and workable, as he became the vital go-between for the Chancellor and the sceptical medical profession. Addison’s role grew from key advisor to Lloyd George’s under-secretary and right-hand man in the wartime Ministry of Munitions – crucial to making ‘war socialism’ a reality even before Asquith was relieved of the premiership. Once Lloyd George became Prime Minister, Addison took his place at the head of the Ministry of Munitions before he was charged with setting up two new government departments. In 1917 this was the Ministry of Reconstruction and then in 1919 the Ministry of Health.
His tenure as Minister of Health – of less than two years – saw plenty of bold thinking about the postwar settlement. This was best embodied in the 1919 Housing and Town Planning Act, remembered as the Addison Act, which established council housing essentially as it’s been known ever since. Yet the implementation of his plans were constantly thwarted and his effectively dismissal in April 1921 (to the post of Minister without Portfolio, from which he soon resigned) is often seen as the moment when Lloyd George opted to remain in office by handing over control of domestic policy to his Conservative ministers.
Like many Liberal reformers, Addison’s future lay with the Labour party. His Lincolnshire farming family background served him well as Minister of Agriculture under Ramsay Macdonald, Labour’s first Prime Minister, before he left office as another unlikely coalition with the Conservatives was formed. In 1945 Clement Attlee brought him back into government, this time as Leader of the House of Lords for the duration of the first Labour government with a Commons majority. He also served as Secretary of State for the Dominions, playing an important part in Labour’s anti-imperial policies, until his health declined in 1947.
This means Addison held government posts under every non-Conservative Prime Minister for half a century, playing key roles in domestic, foreign and constitutional affairs. He deserves to be remembered as a major figure in the progressive politics of early and mid twentieth-century Britain.
Robert Morant, 1863-1920
The Ministry of Health’s first Permanent Secretary was a very different figure. Where Addison’s family had found the money (which he duly paid back) to send him to Trinity College, Harrogate then Sheffield School of Medicine, Morant’s widowed mother found enough to send him to Winchester College before he needed to take up private tutoring to pay his way through New College, Oxford in the 1880s. His disappointing third-class degree in classical moderations (before a rather superfluous first in theology) didn’t hold him back from ending up private tutor to the crown prince of Siam only a few years later.
His passionate advocacy of English educational values as part of an imperial civilising mission led to him being called the Big Teacher, and less favourably accused of behaving like ‘the Uncrowned King of Siam’. If he was a less controversial figure once he returned home to England, he was no less an oddity. Beatrice Webb said he was ‘a strange mortal, not altogether sane’, yet also ‘the one man of genius in the Civil Service’; while to Florence Nightingale he was ‘a good genius’.
His atypical career path and personal energies saw him work his way into, and swiftly to the head of, the Board of Education. His time there was marked by an effective reorganisation and a raft of progressive policies successful implemented under Conservative and Liberal administrations. This earned him an offer from Lloyd George in 1909 of a significant pay rise if he moved to the Development Commission, which he turned down to stay at the Board of Education. Two year later, however, politically damaging criticism from the chief inspector of elementary schools meant he was happy to take up a new offer and move to head up Lloyd George’s new National Insurance Commission.
From the beginning, Morant made it clear to Lloyd George he saw implementing the National Insurance Act as a step towards unifying the complex patchwork of medical services of the day. He was no socialist but believed strongly in effective administration. He pushed Lloyd George to devote greater resources to staffing than he had intended, over-riding financial concerns at the Treasury. So his appointment as Permanent Secretary of the new Ministry of Health can only have been intended as one in which he would continue to be a forceful advocate of progressive policies and bigger government. Indeed, if he had not died of pneumonia only a year later, the deviousness commented upon by his critics and admirers alike would undoubtedly have been aroused against the Conservative attacks on the ambitious reform plans of the new ministry.
George Newman, 1870-1948
For George Newman, studying medicine in Edinburgh then at Cambridge was an alternative to continuing the missionary work of his Quaker father. In 1900, after turning down the post of government bacteriologist in the India Office, he moved from university teaching into local government public health work, and in 1906 produced his seminal report Infant Mortality: A Social Problem. His successful solution of a milk depot in Finsbury Park was indicative of a shift from curative to preventive medicine he would advocate throughout his career. It also attracted the attention of Beatrice Webb, who introduced Newman to Morant, who in turn appointed him as the first Chief Medical Officer at the Board of Education in 1907.
Newman headed up the introduction of the School Medical Service from the Board of Education, something seen by many in the medical profession as a worrying expansion of the state. He was also involved, again alongside Morant, with the implementation of National Health Insurance – ensuring institutional treatment for tuberculosis was included where no other hospital services were. This fell far short of the universal health service he wanted, but like many progressives he saw it as an important step in the right direction.
Like Morant he turned down a tempting government offer away from the Board of Education out of a commitment to the pioneering reforms he could implement from there. Unlike Morant, however, the First World War saw him in demand elsewhere. He worked on the establishment of factory canteens as an alternative to less sober venues, measures to maintain the health of industrial war workers and the setting up of Quaker ambulance services on the continent.
His appointment as the first Chief Medical Officer at the Ministry of Health ensured the three highest positions in the new department were held by men with strong track records in delivering radical reforms. Yet he soon found himself without his allies. His primary contribution thereafter was to national debate, through his influential annual reports on the health of the nation, as well as a great many books and lectures. He died an old man, after a career dedicated to the cause of unified, universal and preventive medical services, just weeks before the introduction of the National Health Service in 1948.
Addison, Morant and Newman were Lloyd George’s ministry men – the radical reformers chosen to set up the government department at the heart of his ultimate failure to provide homes fit for heroes. Each of these men was influential in a different way. But none were second-rate appointments.
Cross-posted on the author’s personal website