Public Health

Edwin Chadwick
1. Government took action in 1839 and set up an enquiry
  1. Appointed Chadwick, government official, in charge
2. 2 year enquiry
  1. Doctors sent to major towns and cities to question people and fill out questionnaires
  2. 1842 - published report that shocked British people
    1. 10,000 free copies to anyone who could help (politicians, journalists etc.)
    2. 20,000 copies sold to public to raise awareness
  3. Conclusions
    1. Improve drainage, water supply, streets and roads
    2. Remove rubbish from houses
    3. A healthier workforce could work harder
    4. Bad ventilation is killing people
      1. Miasma
3. Believed in miasma theory
  1. Conclusions drawn were correct though
4. Government didn't take action
  1. Laissez faire - Government's job to keep the law not to keep the people clean
Problems in 1850
1. Overcrowding (back-to-back housing) - disease spread quickly
2. Sewage water ran into rivers where people washed and drank from
3. No waste or rubbish disposal
  1. Sat in the streets
4. Badly ventilated housing
5. Government's 'laissez faire' attitude
6. Cholera
  1. Caused by contaminated food/water
  2. 1831 - killed 50,000 people
  3. No knowledge of the way it spread or the cure
Return of Cholera 1848 led to the 1848 PUBLIC HEALTH ACT
1. What it did
  1. Local councils given power to spend money clearing towns if they wanted
  2. National Board of Health created
    1. Power to set up local health boards in areas with high death rates
      1. They have power to make sure new houses have drains/toilets
      2. Charge local tax to pay for improvements
      3. Appoint medical officers to 'inspect nuisances'
2. Limitations
  1. No obligations
    1. Only 103 towns set up boards of health by 1853
  2. Didn't end cholera
    1. 1854, 20,000 more people died
  3. Could use taxes for other things
  4. Paid for by people who can least afford it
  5. Improvements required constant funding which was often lacking (i.e. public toilets)
  6. Only committed some towns to change
  7. No money set aside to investigate causes
  8. Rich people less inclined to set up/pay rates as it doesn't affect them
3. Changed very little due to voluntary nature
John Snow (1854)
1. Famous surgeon who worked in Soho
2. Decided to try and find cause of cholera
3. Observed Broad Street, where he worked
  1. Found all victims of cholera got their water from a certain pump
    1. He removed handle to prevent people from using it
  2. No more deaths in the street
  3. Street toilet had a cracked lining that was leaking sewage into the water source
4. Proved...
  1. Cholera was not carried through the air (miasma)
  2. Spread through contagion
5. Government
  1. Maintained laissez faire approach
Public Health Acts
1. Working Class Vote (1867)
  1. Politicians wanted improved public health to be a reason to vote for them
  2. 1874 Conservative win was mainly due to working class
2. 1875 Public Health and Housing Acts
  1. Sewers must be clean and rubbish cleared from streets
  2. Councils have power to pull down substandard housing and build improved homes
3. 1853 Compulsory smallpox vaccination
  1. Every baby
  2. Soon, deaths dramatically dropped
4. Boer War 1899-1902
  1. 40 out of 100 men who applied unfit to serve
  2. Liberal Party (1906) decided to introduce free school meals
5. 1907 - School clinics
6. 1908 - Children and Young Person's Act
  1. Made children 'protected persons' (i.e. neglect was illegal)
7. 1909 - back to back housing banned
8. 1911 - pensions for the elderly introduced
  1. No workhouse
9. Post WWI reforms
  1. 1918 - local councils must provide health visitors, pregnancy clinics and day nurseries
  2. 1930 - Slum clearance programme
    1. Improving children's lifestyle who lived there
  3. 1919 - local councils to build new houses for poorer families
Great Stink
1. A heat wave in 1858
  1. Thames smelled worse than before
  2. Stink reached parliament and so...
    1. Government were affected for the first time
2. Change of attitude
  1. Government wanted to implement health reforms to get poor's votes
3. Sewer system
  1. 1855 - Joseph Bazelgette designed a new sewer system for London
    1. It would collect all of the waste from nearly 1 million London houses
  2. Waste would be pushed by pumps towards the sea
  3. Given £3m by government
    1. Equivalent of £1bn today
  4. Finished in 1866 and would remove 420 million gallons of water a day
4. New acts were introduced that forced people to comply from the Great Stink onwards
By 1940...
1. death rate had dropped
2. life expectancy had risen
3. government more interested in Public Health (political motivation)
The Beveridge Report
1. William Beveridge - liberal politician
2. Government commissioned to find out what people wanted Britain to be like after the war
3. 5 things that Britain needed were concluded...
  1. poverty
  2. disease
  3. ignorance
  4. idleness
  5. squalor
4. Proposed setting up a welfare state
  1. social security
  2. NHS
  3. free education
  4. council housing
  5. full employment
  6. Labour government tried to make this vision come true after the war

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