3.2 Changes in public health Flashcards
How was parliamentry legislation at first?
tentative, with permissive acts that could be accessed should local authorities wish to do so
When did government become committed to public health (PH) and when were acts dealing with Public Health compulsory?
Early years of the 20th century. Clean water and effectice sanitation were no longer optional
Was central or local gov more powerful?
Central gov could legislate for public health, but it was in the localities that it was implemented; when central gov was permissive, a local council could decide to spend money on civic buildings rather than on drains; even PH acts had to be implented by local councils
Why was there a slow change to local and central involvement in public health?
Unprecedented population growth in the 19th century
If local gov had more prominent intervention, did this mean that local authoroties ignored the issue of public health?
No. Pioneering work was done in certain towns and cities by individual medics and admins
Who was behind the formation of the Manchester Board of Health in 1795?
Thomas Perceval and John Ferriar.
Who published reports in Scotland on public health in the early 19th century that prompted authorities to act?
Robert Graham, Robert Cowan and James Cleland
Problems with Scottish reports?
Piecemeal and initaives were only local. Due to diff local admin w/ diff ppl and diff priorities, public health schemes wld collapse
What else was piecemeal?
Private Acts of Parliament secured by local authorities relating to PH.
How many Acts of Parliamnent did London operate under?
In London, there were 300 diff bodies w/ an interest in PH and these operated under 250 Acts of Parliament
How many paving baords did St Pancras have?
The London parish had 16 paving boards, responsible for paving the streets of the parish under 29 Acts of Parliament
What went wrong with St Pancras and the many Acts of Parliament?
Admin nightmare and repeated throughout Britain i.e in Lancashire and Exeter. These allowed commissioners to be elected by ratepayers to deal w/ specific problems depicted by the Acts
What was Vested interests?
The ppl more likely to support a measure if they will benefit frm the measure; they were night soil men to clergy and owners of water companies who were either paid off or represented on the improvement committees themselves.
What did Leeds and Manchester do when taking advantage of their new status under the Municipal Corporations Act?
The Municipal Corporations Act 1835 meant that both towns assumed control of paving, sewerage, street cleaning, and draining. However, they still needed a private Act of Parliament to help them do it, and it was not cheap.
What happened when Liverpool obtained a Sanitary Act in 1846?
The Sanitary Act made the corporation a health authority and empowered it to appoint a medical officer of health. Thus, the town council was given power to carry out improvements to sewerage, drainage, and water supply.
Who was the first medical officer of health in Britain?
WH Duncan (appointed by Liverpol town council)
What overshadowed the immediate implementation of the 1848 PH Act?
Second cholera outbreak that hit Britain. Plus, it was easy for the Act to be undermined so its effectiveness was patchy
Three successes of the PH Act 1848?
Start of 1850 = 192 towns asked for the new ph regulations to be applied & the Act had been applied to 32 of them; by 1853= this rose to 284 petitions & there were 182 towns where the Act was applied; there were town councils that took the Act further through private Acts of Parliament that gave them more sweeping powers
Three failures of the PH Act 1848?
- Lancashire = only 40k of its 2.5 mil ppl were living under some sort of PH board. 2. Of the 187 major towns in the UK, only 29 had the powers of draining & cleansing; 30 had absolutely no powers over PH because powers were in the hands of independent commissionders; 62 had no PH authority whatsover. 3. Local boards of health (BOH) were often j the existing town corporation under a diff guise, so movved slowly, hesistantly, and cautiously.
Why did the PH act od 1848 not have that much impact compared to the Poor Law Amendment Act 1834?
public and gov were not convinved that order needed to be brought into the private Acts relating to PH, no existing structure that cld be reformed; med knowledge was not giving clear msgs, vested interests in water companies, local commissioners scared of losing their job
How was the PH act of 1848 a turning point?
Marked the start of the state’s intervention in PH, and the start of the termination of the need for private Acts of parliament to deliver PH for those whom councils were responsible for. In the years to 1939, increased understanding abt the causes, transmission, and prevention of disease, the pioneering work of individuals and willingness of authorities to support PH initiatives meant PH improved.
What did the health of the poor and vulnerable rely on?
Provision of good quality & cheap housing. Clean water supply, sewerage systemm, and knowledge abt disease transmission meant nothing if the poor lived in overcrowded conditions
What towns and cities inserted clauses into their own Improvement Acts that let them control buildings, sewerage connections, and cellar dwellings?
Leeds & Liverpool in 1842, Manchester in 1844/45, Nottingham and St Helens in 1845, London Metropolitan Building Act 1844 ( all newly constructed buildings within 30 feet of a common sewer to be connected to it.)
Problems with giving city authorities control?
Giving control was not the same as the authority acting; w/o a building inspectorate, 100s of new buildings didn’t conform to the supposed regulations implemented.
What did the Local Gov Act 1858 do?
Set out model by-laws & 10 yrs later = 568 towns used them.
Problems w/ Local Gov Act 1858?
Although building regulations were available in the 1860s, their impact was not so good. Vested interests fought them thru local courts; localities developed their own variants, and problems w/ enforcement. PH Act of 1975 that clearly set out the powers of local authorities were in regards to building regulations. So bcuz of the firmness & clarity of the PH act, local gov laid down by-laws in 1877 like systems of drainage, building height, and street width.
Other building regulations implemented that would expedite the effect on PH?
1) The Common Lodgings House Act 1851 & 53 made all lodgings registered and inspected by cops; however, rarely enforced and badly drafted. 2) A Nuisances Removal Act 1855 empowered authorities to combat overcrowding as a nuisance w/ fines etc. 3) The Sanitary Act 1866 placed limitations on using cellars for occupation 4) The Artisans and Labourers’ Dwellings Act 1868 gave local councils the power to force a landlord to repair an insanitary hse. 5) The Artisans’ and Labourers’ Dwellings Improvement Act 1875 gave local councils the power to clear whole districts, not j hses.
What did Brimingham’s mayor (Joseph Chamberlain) do?
The last two acts were permissive. Chamberlain started a huge slum clearance programme; town council bought slum houses to replace them w/ law courts and shopping centre
What did PM Lloyd George promise WW1 soldiers?
that they’ll return to a land ‘fit for heroes’ (in relation to house building)
Problems in 1918?
rise in the cost of building materials slowed any rebuilding programs + poor workers cldnt afford hses
What was the Housing Act 1919?
gov subsidies given to local councils & private builders to enable them to build affordable housing for ppl on low incomes. Called council houses; had waiting lists
What happened 11 yrs after 1919?
Gov offered councils a special slum clearance subsidy to encourage councils to pull down slums; was not good as in 1933 councils asked to prep 5 yr program to remove slums
What was housing like by 1939?
Most houses in towns and cities had piped water and were connected to a sewerage system. Only 50% had a hot water tap and a fixed bath.
What did George Peabody do for housing?
He founded Peabody Donation Fund to provide model dwellings for the London poor. First block of flats opened in Spitalfields in 1864 with toilets, baths and laundry facilities. Larger estates were built in e.g. Westminster. By 1882, the Trust was housing more than 14,600 people in 3500 dwellings; 1939= 8k dwellings & 33k ppl
What did Titus Salt do for housing?
Bradford mill owner. In 1850s moved his factory & its workers into purpose-built village of Saltaire. Had mill, houses, school, park, alms-houses, hospital. BUT Strict rules (e.g. no union joining
What did Octavia Hill do for housing?
Bought run-down artisans’ cottages, renovated them. Let them out at low rents to poor ppl. Mid 1870s had 3k tenants. Worked w team of women rent collectors. Believer in self-help and self-sufficiency for poor
What did Ebenezer Howard do?
Wrote ‘To-Morrow: A peaceful Path to Real Reform’ in 1898. Developed theory that ppl should live in harmony w nature in towns where there was lots of green space. Started garden city movement. E.g. Letchworth built - 1st garden city
What did William Lever do?
New site for his soap making business & new model village for his workers. 1899-1914: 800 houses were built at Port Sunlight w allotments, cottage hospital, schools, concert hall, open-air swimming pool, church. Introduced welfare schemes & provided entertainment
How many people did the 1837-40 Smallpox epidemic kill?
42,000
What was done to combat Smallpox (apart frm vaccine as there alr was one but sm anti vaxxers)?
1) Permissive Vaccination Act 1840: vaccine available to everyone free of charge, Poor Law medical officers gave it out 2) Compulsory Vaccination Act 1853: obligatory for parents to vaccinate their children w/in 3 months of birth. If failed to comply = £1 fine, money went towards the poor rate
How many people did the 2nd smallpox epidemic kill (1870-73)?
44,000
What was done to combat Smallpox epidemic pt2?
Compulsory Vaccination Act 1871: obligatory for local health boards to appoint vaccination officers & imposed fines of 25 shillings on parents who refused to have their child vaccinated.
What opposition was there to the smallpox vaccine?
rights of individual, fear of central government intervention in local gov, religious objections
