Born in Greenside, Wortley, William Hall was the son of a surgeon, Matthew Hall. Following the death of his father died in 1848, he was apprenticed to Dr Radcliffe of Kirkgate and although only 15 years old he was thrust into caring for the sick during the cholera epidemic of 1848 ,becoming well-known amongst the Irish community as ‘the little doctor’. Later he studied medicine at the Leeds School of Medicine supplemented by some training at Guy’s Hospital in London. By 1850 he was back in Leeds working as a surgical dresser to the celebrated surgeon, Samuel Smith (1790-1867)1. Having his own first-hand experience of the distress of the poor, Hall’s concerns were augmented by those of Dr Smith who worked unceasingly against the employment of small children in factories, and from 1831 lectured on midwifery and the diseases of women and children at the School of Medicine, a position which Hall himself was to occupy from 1856-1875. Rather than established his own surgery in some fashionable part of the town, he opened his first practice in 1851 in a house opposite the Parish Church, moving to North Street and then Springfield House in Burmantofts. He was also employed as a factory doctor and from 1864 was a surgeon at the Women’s Hospital before retiring from medical practice in 19022.
Born in Greenside, Wortley, William Hall was the son of a surgeon, Matthew Hall. Following the death of his father died in 1848, he was apprenticed to Dr Radcliffe of Kirkgate and although only 15 years old he was thrust into caring for the sick during the cholera epidemic of 1848 ,becoming well-known amongst the Irish community as ‘the little doctor’. Later he studied medicine at the Leeds School of Medicine supplemented by some training at Guy’s Hospital in London. By 1850 he was back in Leeds working as a surgical dresser to the celebrated surgeon, Samuel Smith (1790-1867)1. Having his own first-hand experience of the distress of the poor, Hall’s concerns were augmented by those of Dr Smith who worked unceasingly against the employment of small children in factories, and from 1831 lectured on midwifery and the diseases of women and children at the School of Medicine, a position which Hall himself was to occupy from 1856-1875. Rather than established his own surgery in some fashionable part of the town, he opened his first practice in 1851 in a house opposite the Parish Church, moving to North Street and then Springfield House in Burmantofts. He was also employed as a factory doctor and from 1864 was a surgeon at the Women’s Hospital before retiring from medical practice in 1902.2
Dr Hall’s special concern was the health of children, and today we would probably describe him as one of the pioneers of preventative medicine. With the approval of the School Board in 1902 he medically examined 1,600 board school pupils3. His findings were startling: although living in similar streets (probably in the Leylands), he found that Jewish children weighed more and were taller than non-Jewish children, the incidence of rickets amongst the non-Jewish children in his sample was 45% as opposed to 17% amongst Jewish children. He reported a similar disparity in terms of tooth decay, just over half of his non-Jewish group had poor teeth whilst the corresponding figure for Jewish children was 27%4. Visiting gentile homes, he rarely found any milk, children seldomly ate meat and subsisted largely on a diet of bread with margarine or treacle, and tea without milk whilst in Jewish families although equally poor, he found milk, eggs, fresh vegetables, some fish, sustaining soups. The details of Hall’s research were publicised nationally, contributing to a contemporary national debate about the physical deterioration of the British ‘race’5.
In part this debate been unleashed by the Boer War of 1899-1902. Not only had three out of every five military volunteers found to be unfit for military service, but the war itself was seen by many as a shocking national humiliation – expected to last only a few weeks, it took three years for the British Army of 400,000 men to defeat the 88,000 soldiers of the Boer Republics. Other contributing factors were the rise of the labour movement, the economic rivalries with Germany and the USA, and threats to Britain’s position as the dominant world power. Laissez- faire which had dominated for much of the 19th century thinking was beginning to come under attack and a New Liberalism was emerging which sought to overthrow the old shibboleths of individualism and voluntarism in favour of greater state intervention to promote the common good.
Following his retirement, Dr Hall devoted his life to championing the rights of children to lead healthy lives. In 1903 at his own expense to demonstrate his theories about the relationship of health and food he set up a pilot group of 60 seven-year-olds who were given half a pint of milk and bun each day and after six months he found that their weight and general well-being had improved. During the Christmas holidays, the same children were given a dinner of meat and potato pie as well as a glass of milk and a bun6. The experiment was then extended by providing breakfasts was for 100 children using as a kitchen a cellar in St Peter’s Square School. The Local Education Authority became involved by providing more spacious accommodation, and the Board of Guardians provided some funds for the several hundred children to be fed every day. By 1908 800 children were being served with nourishing food often served by Hall himself. Although it was no longer possible to regularly weigh individual children, Hall was reported as having ‘the proud pleasure of watching crooked limbs straighter, bodies plump, faces become bright and happy’7.
Dr Hall became a tireless campaigner for poorly nourished children. He bombarded the local press with letters and spoke at meetings all over the country often illustrating his talks with ‘before’ and ‘after’ photographs. For example, in 1904 he spoke for one and a half hours on Food and Physical Development at a meeting in York chaired by Seebohm Rowntree. His major theme was the lack of bone-making foods in the diet of the slum child. The problem, he argued began in infancy: fifty years ago, when he first visited the homes of the poor, babies were breast-fed at least for the first twelve months of their lives, now he believed that only 10% of poor mothers did this. ‘The pinch of poverty compelled the mother to go out daily outside the home. In my capacity as a certifying surgeon under the Factory Act, he examined 120,000 children as to their capacity for factory work and I am confident that children’s teeth were better and less decayed’8. This argument was repeated in Hall’s contribution the British Medical Association Conference in Oxford in July 1905. After debunking members who argued in favour of hereditary factors (‘environment will knock hereditary into a cocked hat’) Dr Hall declared that ‘food altered the whole condition of the individual … and deterioration was due to poverty … Formerly a woman stayed at home but now it became necessary for her to leave her fireside and work for her family’.9
Earlier in the year, Dr Hall had appeared before a public meeting on underfed children at Leeds Town Hall. Having acknowledged that there were probably 3,245 poorly nourished children in the city, the mayor of Leeds, Robert Armitage pointed out despite what was being done in nearby Bradford, legally there was little that the City Council could do about this dire situation. The matter had to be dealt with either by voluntary subscriptions or the Board of Guardians. Hall’s response was that it cost only 2d to provide a wholesome dinner for a child, and for him there were only two possible courses of action: ways must be found of increasing voluntary subscriptions or intervention by the State, and Leeds Corporation needed to vigorously lobby the Government for a change in the law. He even made the radical proposal that the state should compel employers to subtract money from parents’ wages to cover the cost of school meals10. Hall’s was not a voice in the wilderness. All over the country there were philanthropic efforts such as his own, to provide meals for undernourished children but such ad hoc arrangements were proving incapable of solving the problem There was actually a School Dinners Association, and the National Union of Teachers at their annual conferences regularly stated that that poor pupils were unable to benefit from what was now compulsory state education because they were too hungry to be able to concentrate on their learning. Even the Inter-Departmental Committee on Physical Deterioration set up in the wake of the Boer War in 1903, recommended that if voluntary schemes were unable to cope then Local Authorities should be given the power to intervene.
There were of course powerful forces against such intrusion into individual rights and extension of state power11. Even the Chief Medical Officer of the Board of Education disputed the need for new legislation. His advice to Local Authorities was that ‘only persistent, kindly and consistent missionary effort, would persuade people to change their eating habits’and he went on the suggest that ‘LEAs focus on the promotion of health education and encouraging parents to make their homes suitable training grounds for children of good nutrition and sound physique’12.
The 1906 General Election returned a Liberal administration, the first for twenty years. Though the Prime Minister, Campbell Bannerman was an old-style Liberal, the voice of New Liberalism was making itself felt. Fred Jowett elected as an Independent Labour Party for Bradford West, immediately introduced a private members bill to allow Local Authorities to levy an up to half penny rate to fund a programme of providing school meals for poor children. The legislation was carefully guided through the House of Commons by Robert Morant, the Permanent Secretary to the Board of Education. Perhaps because this permissive legislation, only between 20-30 Conservative MPs opposed the Act. The following January, an Education Circular was issued to all LEAs explaining that the purpose of the legislation was ‘to ensure that children attending public elementary schools shall as far as possible, be no longer prevented by insufficiency of food from profiting by the education offered in our schools’ . Only 4% of Local Authorities adopted the Act immediately. Leeds was not one of these. In 1906, the Liberal lord mayor of Leeds, Joseph Hepworth offered £500 for the provision of what were called ‘food feeding stations’13. This act of private philanthropy was clearly not a permanent solution but in the short-term it staved off the need to make a decisio0n about the 1907 Act. When a year later the city adopted the school meals legislation, it was with some reluctance and to was to be funded by only an eighth of a penny rate. Over-all the impact of the 1906 Act was a gradual one, only 113/328 LAs adopted the legislation before the First World War and only about 8% of school children were in receipt of school dinners – in fact school diners didn’t become the norm until after World War II.
Two years later partly through the campaigning zeal of Margaret McMillan and James Kerr former colleagues in Bradford, the 1907 made the medical inspection of school children, compulsory14. The administration of the legislation was complex, initially LAs used voluntary hospitals and private practitioners to carry these examinations, usually about three times in the pupils’ school life and the results of the examination were passed on to their parents. As with the 1905 Act, Leeds was tardy in its response, it was put into operation in May 1909 with the appointments of one part-time School Medical Officer and 20 part-time staff (all of whom were local GPs), a year later the post of School Medical Officer was made full-time. Whilst Dr Hall had also campaigned for the legislation, for him it didn’t go far enough, pointing out that the Act drew a distinct line between inspection and treatment, the latter remaining a parental responsibility. In 1912 Leeds appointed its first School
Nurse, partly to help with medical inspections but also responsible for infestations of lice, (‘the nit nurse’) and in the same year the LEA opened a school clinic in Portland Crescent school clinic in Portland Crescent to tackle the problem of the divorce between inspection and treatment,15. The Corporation also must have made arrangements for local hospitals to treat pupils because in 1916, it opened five branch clinics because the hospitals it had previously been using, were now overwhelmed by nursing wounded soldiers16.
In March 1909 an article and a letter from Hall to the Yorkshire Evening Post caused a hullabaloo in the local press all over the country17. In papers from St Austell to Dundee, articles accused Hall of stating that slum mothers were ‘unmotherly and drunken’. Today we have become used the sensationalising tendencies of the press but having examined both the original article and Hall’s letter, this is not quite what was written. Hall referred to ‘slum mothers having a wretchedly hard time and were inclined in the evening to neglect their homes and families’. In his letter in the same issue of the YEP, discussing the good work accomplished by the Leeds Poor Children’s Holiday Camp, he suggested that ‘fifty years ago mothers were much more cleanly, temperate and motherly than they are today’18. Nowhere did Hall speak of ‘drunkenness’! Obviously, I don’t know why the press responded in this way, was it example of ‘anti-woman’ rhetoric, or a way of deflecting attention away from the need for social reform and laying the blame on mothers?
Later in 1909 National Health Congress was held at Leeds University attended by over 1000 delegates19. In his opening address, Col. T. Harding paid tribute the important contributions made by Dr William Hall to the well-being of children. In his own conference paper, Dr Hall reiterated his view that except for Jewish mothers, most poor mothers had lost their instinct for motherliness. Cultural changes (unspecified) had produced ‘unmotherly mothers … We are still filthy … like the Gadarene swine we rush to our destruction in the pursuit of pleasure’20.
Although primarily concerned with the malnourishment of slum children, Hall was also troubled by their lack of clothing and poor personal hygiene. From 1904 his Leeds Barefoot Mission provided free boots to poor children: ‘Little children like old people have difficulty keeping up their heat. It should not run to wate by uncovered feet in cold weather-want and cold are great destroyers of vitality’21. Between 1904-1912 the Mission distributed 10,000 boots and some pairs of stockings for the poor children of Leeds22. Hall also believed that children’s self-respect was increased by their own cleanliness. In another experiment in 1908 he supplied a school in a poor district with soap, towels, brushes, combs, and hot water and under the supervision of the caretaker and his wife, pupils were given the means to care for themselves. Although this scheme was extended to other schools, it never received the same public support as the Barefoot Mission. In 1912, Hall revived his breakfast project, organising breakfasts in six schools for 3,00O for school children who were not in receipt of free school meals. Present day teachers still maintain that ‘a good breakfast’ is a vital element in successful learning.
Now in his late 70s, hall’s last public appearance I have been able to trace is when he spoke at the Town Hall at a conference during National Baby Week on the need for pure milk, and in his last letter to the press, he threw his support behind the Open Air Schools movement, claiming that ‘there are streets in Leeds in which we can scarcely see a straight leg amongst the children’23 Dr William Hall died at his home, Hillside in Headingley on 30th October 192324
We know little of Dr Hall’s private life. He married in 1862 and for the latter part of his life resided at Hillside on North Hill Road, off Headingley Lane where he must have lived in some style, the house had 13 rooms and three servants. He was a confirmed Anglican worshipping at St Peter’s Church, but about his own political position, we know nothing except that his brother, also a doctor in Huddersfield was an active Conservative. The distress Hall encountered as a young doctor in Kirkgate and his professional contacts with the poor, marked his career. Although Hall was no radical, he came to appreciate that charitable effort was clearly financially inadequate in the face of the magnitude of such suffering and following his retirement, he sought to use his medical knowledge and skills to campaign for state-funded systems of health care particularly in the case of children. As we have seen Hall’s positivist strategies involved experimentation and the collection of relevant statistics (and photographs) to support his views on the need for state intervention. Today Hall’s ‘medicalisation of poverty’ approach has come under attack, and we are much more sympathetic to voluntary action. The condescensions of patriarchy also colour Hall’s notions of ‘motherliness’, and fathers completely escape censure which of course another way of saying that Dr Hall was a ‘man of his time’. Perhaps less excusable was his failure to condemn employers and the entire economic system. In his writings, he does sometimes allude to the issue of low wages but only in passing rather than being the major cause of poverty.
What I found remarkable as I was researching William Hall’s career was how many of his concerns are still with us today: the need for breakfast clubs, meals during the school holidays, the efficacy of breast-feeding infants and the need for fresh vegetables in our diets.
A surgical dresser is the doctor who provides post-operative care for a surgeon’s patients↩︎
- The hospital was founded in 1853. ↩︎
- In nearby Bradford, the city’s first school medical officer, James Kerr carried out the first systematic medical inspection of elementary school children in 1892. ↩︎
- Dr Hall’s research was reported in Yorkshire Post 28th March 1903, 2nd May 1903, 9th May 1903, 19th May 1903 ↩︎
- Contemporaries often referred to the problem as one of ‘national degeneracy’. ↩︎
- Yorkshire Evening Post 23/12/03 ↩︎
- Yorkshire Post 22/7/1908 ↩︎
- Yorkshire Evening Post 23/1/1904. Hall is referring here to the system of part-time schooling which was permitted under the Factory Act of 1878. Children over the age of ten were permitted work and attend school if ‘certified’ by a physician that they were fit for work. Elsewhere he also pointed out the dangers of lead pipes to dental decay. The system was banned in 1918. ↩︎
- Yorkshire Post 27/7/1905 ↩︎
- Yorkshire Post 14/4/1905. In November 1905 an editorial in the Yorkshire Post supported that a proper mean must be provided in all necessitous school, not by charity or increased taxes but funds already allotted to education and a fixed contribution from wage-earning parents before the wage left his employer. (14/11/1905) ↩︎
- In an unsigned letter to the Yorkshire Post a correspondent quoted to an article from The 19th Century magazine which advocated that each elementary school should have its own dining room and kitchen, ‘ Heaven help us’ was the response of the correspondent, ‘is a play master to be employed to direct and superintend games in the interval between dinner time and the re-assembling of school’ ! ↩︎
- John Welshman, ‘School Meals and Milk’, Medical History 41/1 1997, p.11 ↩︎
- The feeding stations were at St Peter’s Square, Jack Lane (Hunslet), Green Lane (Armley), St Philips (Burmantofts) and Nether Green, (Woodhouse) ↩︎
- For an account of Margaret McMillan see – Carolyn Steedman (1990), Childhood, Culture and Class in Britain, Virago Press ↩︎
- Although the 1907 Act did not make treatment mandatory, neither was it proscribed. ↩︎
- David Hirst (1983), The Origins and Development of the School Medical Service, Phd. thesis, the University of Wales. Hirst also gives figures for the numbers of figures treated by Leeds LEA: in 1914 17,060 and by 1908 70,069. ↩︎
- Yorkshire Evening Post 5/3/1909 ↩︎
- The Poor Children’s Holiday Association was founded in 1905 by Mrs Curer Briggs and Miss ME Robinson. Hall was an active supporter of the Association but also aware that it might have unintended consequences, what he called ‘divine discontents’, perhaps two weeks of pleasure only made them more aware of miseries of their lives. For more information on the Poor Children’s Holiday Camp association, see Frances McNeil(2004) ‘Now I am a Swimmer’, Pavan Press ↩︎
- The Congress was organised by Royal Sanitary Institute and Royal Institute of Public Health between 19th -23rd July. ↩︎
- Yorkshire Post 21/7/1909 ↩︎
- Daily News 14/9/1904 ↩︎
- The Barefoot Mission was the precursor of the ‘Boots for Bairns’ scheme established by the Yorkshire Post and LEA in 1921. ↩︎
- The Babies Welcome Leeds Mercury 12/7/1917, Yorkshire Evening Post 29/10/1917. Rickets were a particular concern of Hall’s. Examining old skeletons from the early 19thcentury, he found no evidence of rickets and drew the conclusion that rickety children were a product of inferior diets and lack of fresh air. It was a condition which Hall believed could be cured by cod-liver oil but as he remarked himself ‘prevention is better than cure’ ↩︎
- Obituaries in Yorkshire Post 2/11/1923, Yorkshire Evening Post 1/11/1923, Leeds Mercury 2/11/1923 ↩︎