1.1 Development of services

Services, often charitable services initially, developed in response to the great need for support with child health. The Ladies Sanitary Association, which began in Manchester and Salford in 1860, was the forerunner to health visiting. It involved door-to-door visiting with advice, information, cost-price cleaning products and carrying out minor domestic and nursing duties (Heggie, 2008). By 1905, health visitors were employed in around 50 towns, focusing on preventing ill-health and promoting public health. Health visiting became a universal service run by the Ministry of Health in 1929 (Adams, undated).

Figure 2 A health visitor with a mother and newborn baby, c.1920s

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A black-and-white photograph of a woman holding a baby, in conversation with another woman.

Figure 2 A health visitor with a mother and newborn baby, c.1920s

Between the two World Wars, the poor state of health of the working classes and particularly of children came once again into the spotlight. Rates of neonatal deaths (up to 28 days after birth), postneonatal deaths (from one month to a year after birth), and maternal morbidity (illness) and mortality (death) were highlighted as being very poor, while new diagnostic techniques revealed appalling levels of chronic and sub-clinical disease (meaning disease that had not yet surfaced as having apparent symptoms) in urban children (Bivins, 2014).

During the Second World War, it became evident that families under siege needed help with feeding themselves. Evacuation also highlighted the poor health and nutrition status of many of the young children from inner-city areas. In addition to rationing, a national feeding programme emerged through the development in several local authorities of Community Kitchens. By 1941, a chain of ‘British Restaurants’ were operating across the country, providing cafeteria style nutritious hot food at affordable prices (Atkins, 2011). At the height of the war ‘about half a million people a day (including children) received a cheap but nutritious meal that supplemented their rations’ (Atkins, 2011, p. 151).

Figure 3 A restaurant in London during the Second World War

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Figure 3 A restaurant in London during the Second World War

Following the Second World War, universal services based on a system of National Insurance and taxation were created to support families during times of need, including the National Health Service with its principle of being free at the point of need (Beveridge, 1942).