Changes in Public Health

Question 1

Successes of the 1848 public health act

Answer 1

By the beginning of 1850, 192 towns had asked for new public health regulations to be applied - act had been applied to 32 of them

By the end of 1853, this rose to 284 petitions and 182 towns where the act had been applied

Question 2

Why is the public health act important?

Answer 2

First demonstration of grand scale state intervention concerning the health of the people

Question 3

failures of the public health act

Answer 3

by the end of 1854, only 182 boards had been applied to England, covering 2million people out of a population of 18 million

In Lancashire, only 400,000 of its 2.5 million people were living under some sort of public health board

Of the 187 towns in England and Wales, only 29 had powers of draining and cleansing in the hands of a board, 30 had no powers over public health because they were in the hands of independent commissioners and 62 had no public health authority

Question 4

City of leeds improvement act

Housing

Answer 4

1842

Gave councils the authority to:
- Lay and operate a sewerage system
- Organize public cleansing
- Manage smoke pollution
- Introduce building regulations

Question 5

Nuisance removal act

Hosuing

Answer 5

1855

• Gave local authorities power to combat overcrowding as a nuisance with fines and prosecution

Question 6

Artisans’ and Labourers’ dwelling act

Answer 6

1868
Gave councils power to force a landlord to repair an insanitary house and if not, councils could buy it and pull it down

Question 7

Sanitary act

Answer 7

1866

• Placed limitations on the use of cellars for occupation

Question 8

George Peabody

Answer 8

• Founded the Peabody Trust to provide model dwellings for the London Poor
• The first block of 57 dwellings (flats) opened in Spitalfields in 1864 and contained water closets, baths and laundry facilities
• Larger estates were built in Bermondsey, Chelsea, Islington, Poplar, Shadwell and Westminster
• By 1882, the Trust was housing more than 14,600 people in 3,500 dwellings
• By 1939- had over 8000 dwellings, housing over 33,000 people

Question 9

Octavia Hill

Answer 9

Brought up run-down artisans’ cottages and renovated them by ensuring they were repaired, cleaned, decorated, connected to sewers and provided clean water - let them at low rents for the poor

By mid 1870’s she had over 3,000 tenants

Question 10

William Lever

Answer 10

Found a new site for his soap-making business alongside a model cottage built for his workers

Between 1899 and 1914 - some 800 houses were built at Port Sunlight in Merseyside together with allotments, a cottage hospital, schools, a concert hall, an open air swimming pool and a church

Lever introduced welfare schemes

Question 11

Permissive Vaccination act

Answer 11

1840
Anybody could be vaccinated for free by a poor law medical officer - only widely available vaccinator

Question 12

1st compulsory vaccination act

Answer 12

1853
Made it obligatory for parents to have their children vaccinated for smallpox within 3 months of birth - if parents failed to comply, they were fined £1 which went towards the poor rate

Question 13

2nd compulsory vaccination act

Answer 13

1871
Made it obligatory for local boards of health to appoint vaccination officers and imposed fines of 25 shillings on parents who refused to have their child vaccinated, with imprisonment for those who did not pay the fine

Question 14

Housing act

Answer 14

1919 Housing Act – government subsidies were to be given to local councils and private builders to enable them to build affordable housing for people on low incomes – called council houses – gardens, piped water, inside lavatories

Question 15

TB pasteurisation

Answer 15

1922, Ministry of health ordered the pasteurisation of milk

1934 – act allowed local authorities to make free/subsidised pasteurised milk available to schoolchildren

By 1937 – milk provided to 3.2 million children

Question 16

TB Oldham

Answer 16

• LMoH ordered leafleting of all houses’, stressing TB was highly infectious and could be transmitted in the spit of an infected person
• forbade spitting in public spaces/ railway carriages
• local authority would disinfect houses of TB sufferers
• encouraged the burning of handkerchiefs used by sufferers

Question 17

TB Brighton

Answer 17

The local medical officer of health issued leaflets urging people to only spit into bowls provided

Question 18

What happened to TB as a result?

& Sanatoria

Answer 18

1882 - TB bacillus had been isolated

1911 - 84 sanatoria in the country (8000 beds) providing fresh air, sunlight, good food

Question 19

The Education (Provision of Meals) Act

Answer 19

1906

local authorities could use public money to provide free school meals for the children of needy parents

Question 20

The Education (Administrative Provisions) Act

Answer 20

1907- set up a school medical service ran by local authorities

By 1935- there were 2,300 doctors, 5,300 school nurses and 1,650 school clinics providing medical treatment

Question 21

The Children and Young Persons’ Act

Answer 21

1908
- children made ‘protected persons’ prosecution of neglectful or cruel parents
- All children’s homes were to be registered and inspected
- No cigarettes to be sold to those under 16
Juvenile courts and remand homes set up to separate children from adult offenders

Question 22

What was the significance of Marie Stopes in the development of public health in Britain, and what were her key contributions?

Answer 22

• pioneering figure in women’s health and family planning in early 20th-century Britain
• publication of her book “Married Love” in 1918, which advocated for birth control and sexual health education
• founding of Britain’s first birth control clinic in Holloway, North London 1921, which provided women with access to contraception and reproductive health services - run by midwives supported by visiting doctors
• Clinic not only gave face-to-face contraceptive advice but taught mothers how to use different methods of contraception

Question 23

What was the significance of John Snow in the development of public health in 19th-century Britain?

Answer 23

• pioneering physician and one of the founders of modern epidemiology
• third outbreak of cholera in 1853 - Snow working in Soho
• Suspicious of broad street pump - persuaded authorities to lock the pump handle - number of deaths in soho fell dramatically
• Conducted careful observation and interviews - 535 people lived near a local workhouse close to the broad street pump but got their water from another source - only 5 died from cholera
• Seven workmen who lived outside the area abut worked near broad street and drank from the pump - all died

Question 24

Local Government Act

Answer 24

1888
All medical officers of health in districts with a population of over 50,000 had to be qualified doctors holding a diploma in sanitary science, state medicine or public health

Question 25

Edward Jenner

Answer 25

1788 - aimed to prove that someone with cowpox could not catch smallpox
1796 - conducted experimentation from a dairymaid - took pus from Sarah’s blisters and rubbed scratches onto James Phipps - boy developed a fever but was well again - Jenner established that cowpox could be passed from human to human
- Testes whether cowpox gave immunity to smallpox - variolated the boy with smallpox - suffered no effects - 23 other people, none caught smallpox

1798 - Published his results, parliament gave him £30,000 to establish vaccination clinic in London