Public Health Reform in Industrial Britain (OCR GCSE History B (Schools History Project)): Revision Note

Summary

In the first half of the 1800s, it was believed that the government had no place interfering in public health. This laissez-faire attitude gradually changed over the century. Edwin Chadwick's report argued that there was a clear link between dirt and disease. This led to the Public Health Act of 1848, which was a series of recommendations; it did not force any changes.

In 1854, John Snow proved a link between cholera and dirty water. This was followed by London's River Thames becoming so polluted in 1858 that parliament was closed. This event was known as the 'Great Stink'. John Snow's work and the Great Stink led to demands for government action. Louis Pasteur's Germ Theory was published in 1861 and added scientific evidence to the arguments that dirt was deadly.

After growing pressure from the public, the government passed the 1875 Public Health Act. This forced town councils to provide clean water and to build sewers. This marked the end of the laissez-faire approach to public health.

Towns and cities became cleaner and healthier. As a result, life expectancy in Britain increased.

Edwin Chadwick

• The government commissioned Chadwick to investigate why so many people were becoming sick in Britain's industrial cities

  • He published his Report on the Sanitary Conditions of the Labouring Population in 1842

  • The report provided evidence of a clear link between dirt and disease

    • It also contained recommendations on what the government should do to end the high rates of sickness

  • These recommendations included that the government should:

    • Appoint a medical inspector to each district

    • Close all cesspits and replace them with flushing toilets connected to sewers

    • Supply clean water to all

    • Ensure that all streets remain clear of filth

• Chadwick's report sold in large numbers and was widely read

  • Whilst many people supported his ideas, many people were fiercely opposed to them

  • Some politicians did not believe it was the government's role to become involved in public health

    • This is described as a laissez-faire or 'leave alone' attitude

  • Some wealthy people did not want to pay more taxes to improve conditions in areas where they did not live

  • Water companies did not want to see their profits damaged

The 1848 Public Health Act

• Despite the opposition to Chadwick's report, widespread support for it led to the passing of the 1848 Public Health Act

• It was the first time that the national government had become involved in public health

  • It established a Central Board of Health

  • The Act recommended that towns and cities raise taxes to improve sanitation

• The Act only made recommendations

  • Towns and cities were not forced to take action

  • As a result, it had little or no impact and was seen as a failure

John Snow proves the link between cholera and water

• Dr John Snow investigated an outbreak of cholera in the London area of Soho in 1854

• Snow mapped the locations of all of the victims and noticed they were clustered around the water pump on Broad Street

• Further investigations proved that water from the pump had been consumed by all of the victims

  • It was still not understood exactly how cholera was transmitted, but the link between unclean water and cholera had been proven

• This investigation led to demands for the government to become more involved in improving the living conditions in Britain's cities

The Great Stink, 1858

• The hot summer of 1858 led to much of the Thames evaporating and leaving behind a river running thick with excrement

• The stench from the river was so strong that it forced Parliament (which sits on the banks of the Thames) to close

  • It directly led to Joseph Bazalgette being commissioned to build hundreds of miles of sewers beneath the capital city

• Demands followed for similar sewer schemes to be built in cities across Britain

Louis Pasteur and germ theory

• A French chemist named Louis Pasteur had been paid to investigate why wine was turning bad

• This led to him publishing his Germ Theory in 1861

• Germs had been known about since the 16th century but Pasteur was the first to put forward the idea that they were responsible for disease and infection

  • This was to have an enormous impact on public health, medicine and surgery and led to demands for the government to clean up Britain's cities

• However, the germ theory was not accepted by many people in Britain at first and they stood by the miasma theory

The 1875 Public Health Act

• In 1866, there was another cholera epidemic

• The 1867 Reform Act led to working men being able to vote in elections

  • This combination of events caused there to be more demands than ever for the government to become more involved in public health

• In 1875, the government passed the second Public Health Act

• Unlike the Public Health Act of 1848, this forced councils to:

  • Install sewers

  • Provide clean water

  • Collect rubbish

  • Build public toilets

• It also required them to appoint medical officers and sanitary inspectors to ensure these things are done

• The 1875 Public Health Act also stated that all new houses built had to be connected to drains and sewers and be fitted with flushing toilets and piped water

• The 1875 Public Health Act marked the end of the laissez faire approach to public health in Britain

  • From 1875 onwards, the government became far more involved in public health

Local public health reforms

• As a result of the Public Health Act, town and city councils became more involved in public health

  • Cities such as Birmingham and Manchester competed by building town halls, libraries and museums to display their wealth and power

  • They demolished large areas of 'slums' and replaced them with broad, tree-lined streets of new houses

• Huge engineering projects piped clean water from enormous reservoirs in unpolluted areas such as Wales and the Lake District

• The results of the intervention by both national and local governments on the health of the nation were enormous

  • Average life expectancy rose from 30 to 50