Richard Titmuss. Stewart, John
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By 1945 the state had ‘assumed and developed a measure of direct concern for the health and well-being of the population’, a change which, when contrasted with the 1930s, was ‘little short of remarkable’. This had been achieved through both new and existing services, embracing all social classes. National resources were pooled and risks shared, and acceptance ‘of these principles moved forward the goals of welfare’. Titmuss acknowledged that little of this was planned in advance, but insisted that, for instance, ‘the condition of evacuated mothers and children aroused the conscience of the nation’, which led directly to proposals for reform, leading in turn to state action. To take another example, the expansion of state-provided school meals, previously a poorly regarded scheme, generated something ‘very close to a revolution in the attitude of parents, teachers and children’. From a service with a Poor Law taint, it had become ‘a social service, fused into school life, and making its own contribution to the physical nurture of the children and to their social education’. Further positive attitudinal change could be found in the ‘quality of the Assistance Board’s work, and in the relationship between its officers and its clients’, another contrast to the 1930s. Here Titmuss was referring to the Unemployment Assistance Board, set up in 1934, the cause of much resentment among the unemployed because of its intrusive methods of assessing benefit. Analysing an indicator of social wellbeing in which he had a longstanding interest, Titmuss recorded a wartime fall in the infant mortality rate which would have been ‘considered as a remarkable achievement in peace time’. Indeed, the data showed not just a decline, but one historically almost unprecedented. Reviewing the population’s health more generally, government action after 1939 to ‘safeguard the nation’s health’ had been ‘far more effective than anyone expected or thought feasible’ before that date. But what Titmuss was especially keen to emphasise was a change in values early in the conflict when invasion threatened, followed by the bombing of major urban areas. If ‘dangers were to be shared, then resources should also be shared’. So commonality of purpose meant benefits in common, but also obligations on the part of individuals, one to another – ‘Dunkirk, and all that name evokes, was an important event in the war-time history of the social services’. The subsequent difficult years ‘served only to reinforce the war-warmed impulse of people for a more generous society’.40
It should be stressed that Titmuss was neither naïve, nor an unthinking optimist, anxious only to show the British at their best. He recognised that, even with the improvements which had been made, certain social problems still had to be addressed – hence the ‘Unfinished Business’. It is therefore important to remember that the book was published in 1950, by which time the key measures of the ‘welfare state’ were in place. We do not know precisely when Titmuss wrote this chapter, but it seems likely that he was already looking forward to what social policy might achieve. What we do get, though, is the very strong sense that the war had brought about a fundamental change, especially in social values. The clear message of this chapter, and it is different in tone from the statistically dense other parts of the book, was that people working together, with duties as well as rights, can, within a framework of beneficent state action, build a better society – the new Jerusalem promised by Labour leader Clement Attlee during his successful 1945 election campaign.
In August 1944, Titmuss told Lady Allen of Hurtwood (Marjory Allen) that any history of the wartime social services would be incomplete ‘without reference to the work of the voluntary organisations operating in this field’. He was, therefore, seeking information from Allen in her capacity as Chair of the Nursery School Association, a body which campaigned for expanded pre-school educational provision. A meeting was duly arranged for late September.41 Although their early correspondence is formal, it seems likely that Titmuss and Allen already knew each other. Both moved in ‘progressive’ political circles. Allen’s husband, for instance, had founded the ‘Next Five Years Group’, a body committed to social and economic reform, especially active in the mid-1930s.42 In any event, they built up a working relationship in which Allen sought Titmuss’s advice, while he made a number of revealing comments about the current state of welfare provision, and thereby his own approach to the social services.
Shortly before their meeting, Allen wrote to The Times on ‘Children in “Homes”: Wards of State or Charity’. She raised the issue, as yet unaddressed by plans for reconstruction, of ‘those children who, because of their family misfortune, find themselves under the guardianship of a Government Department or one of the many charitable organisations’. Many were being brought up ‘under conditions that are generations out of date and are unworthy of our traditional care for children’. Of these, a large number still lived ‘under the chilly stigma of “charity”’, and in both public sector and charitable homes many staff lacked formal training, and were not subject to inspection. Allen therefore called for a public enquiry into ‘this largely uncivilised territory’.43 Even such a brief summary might suggest why Titmuss and she would get along, the lack of professionalism in children’s homes being a case in point. And Allen, like Titmuss, was highly critical of ‘charities’ which, due to their dependence on state support, were not truly voluntary bodies. Early in 1945 she expanded her case in the pamphlet Whose Children?, a copy of which she sent to Titmuss. Titmuss recorded that at their September meeting some of the points Allen had raised related to the unrepresentative composition of the governing bodies of many voluntary homes while, in her view, the ‘Orphanages and Homes run by the Roman Catholic Church are the worst’.44
In response, Titmuss noted that Allen’s analysis would be incorporated into Problems of Social Policy. In a revealing comment about what he saw as the current shortcomings of officials in both voluntary and public welfare, he told her that ‘You know it is the same type of mind that dominates the governing bodies of the charitable homes and the Public Assistance Committees. But what minds and what a shocking indictment it is!’45 He was also critical of any welfare provision which smacked of ‘charity’, and the stigma it entailed. But it would be wrong to read Titmuss’s letter as an attack on voluntarism as such, for what he was suggesting was that the manner in which social services were delivered was just as important as who was doing the delivering. As far as the voluntary sector was concerned, a distinction could also be made between patronising ‘charity’, which might actually be heavily reliant on state support, and unselfish, altruistic voluntarism.
Partly because of Allen’s agitation, an official committee, chaired by Dame Myra Curtis, was set up to examine the situation of children ‘deprived of a normal home life’. Allen told Titmuss how pleased she was with how quickly the government had acted, and that the committee’s ‘terms of reference are excellent and very wide’.46 The Curtis Committee reported in 1946, with its major proposals being incorporated into the 1948 Children Act, an important, if sometimes neglected, component of the ‘welfare state’. Among the recommendations implemented were that local authority children’s departments should be established, and that there should be a move