Public Health - 3.2 Flashcards
1
Q
what did local government do?
A
- pioneering work done by individuals in towns and cities (e.g. Thomas Perceval and John Ferriar were behind the formation of the Manchester Board of Health in 1795)
- Robert Graham and others published reports on PH in 19th century Britain
- different personal had different priorities leading to different schemes
- piecemeal implementation of private acts obtained by local authorities that related to public health (e.g. London was under the administration of 300 different bodies under 250 acts of parliament, this was an administrative nightmare)
- Lancashire had an act for ‘lighting with gas the town of st Helens)
2
Q
failures of local government action
A
- by the 1830s town improvement committees were seen as corrupt. various grouping of officials created self perpetuating oligarchies and vested interest meant certain interests were prioritised.
- no continuity, every area was different
3
Q
successes of local government action
A
- could pass their own acts meaning it could be tailored to suit the area’s needs
- Liverpool, Leeds, Manchester and London are good examples,
- in 1846 Liverpool obtained a sanitary act empowered it to appoint a medical officer of health
4
Q
oligarchies and vested interests
A
- government by a small group of people, a self perpetuating year on year
- this phrase is used to suggest that people are more likely support a measure if their families of social groups will benefit.
5
Q
successes of public health act 1948
A
- by 1853, it had 284 petitions and there were 182 towns where the act had been applied
- in Lancashire only 400,000 of its 2.5million people were living under some sort of public health board
- of the 187 major towns in England and Wales, only 29 had the powers of drawing and cleansing in the hands of one board
- marked the beginning of state intervention in public health matters and the end of private acts
6
Q
limitations of public health act 1948
A
-implementation was patchy and was overshadowed by the second cholera outbreak
-deficit between the number of applicants and where it was applied
-enthusiasm of towns like Rochdale has to be put into context and set against the strengths of vested interests and reluctance of many local authorities to pay for something they considered unnecessary
-the government were not convinced that order needed to be brought into the bewildering multiplicity of private acts relating to public health
-no existing structure to be reformed and the medical community was giving mixed messages
-
7
Q
housing
A
- provisions of clean water, sewage etc were nothing if the poor lived in squalor
- housing had to be cheap if the poor were to afford it and herein lies the problem. no speculative builder was going to build good quality housing that was also cheap, no landlord would charge lower rents than obtained on the open market for properties he owned
- there was no clearly defined housing policy until the end of the 19th century. some towns and cities inserted clauses in their own private improvement acts empowering them to have some control over improvement acts (e.g. Leeds and Liverpool in 1942)
- metropolitan building act 1844 gave London powers that said all newly constructed buildings within 30ft of a common sewer had to be connected to it
8
Q
housing acts in the 50s and 60s
A
- common lodgings act 1851 and 53 laid down that all lodging houses were to be registered and inspected by the police. however, they were badly drafted and rarely enforced
- Nuisance Removal act 1855 let authorise combat overcrowding with fines and prosecution
- Sanitary act 1866 placed limitations on the use of cellars for occupation
- Artisan and Labourers dwellings act 1868 gave powers to force landlords t o repair insinuatory houses, if not the council could pull it down
- Artisian and Labourers Dwellings Improvement act 1875 gave local councils the power to clear whole districts not just individual houses
9
Q
what did the LGA 1858 and PHA 1875 do for housing?
A
- always problem of enforcement and vested interested meant that local governments always developed their own variants of the law
- latter set out very clearly what the powers of local authorities were with regard to building regulations and it was because of the firmness and clarity of this act that standard local government by-laws were laid down in 1877 (width of streets and height of buildings)
10
Q
drawbacks of housing
A
- the Artisans’ and Labourers Dwellings acts were permissive. some councils adopted them with alacrity
- Birmingham for example began a slum clearance programme under major Joseph Chamberlain buying four acres of slum houses and instead building new law courts and a shopping centre
- however, the people who lived there had to make do the best they could
- highlighting problem that the act made no provision for the compulsory housing of those made homeless by slum clearance
- wasn’t until 1890 (London) and 1909 for the rest of the country that councils were obliged to rehouse at least half of the people evicted
11
Q
impact of ww1 on housing
A
- house building stopped altogether and house repairs were minimal
- George’s promise of clearing slums and making a ‘land for for heroes’ rang hollow
- the war caused a rise in building materials slowing programmes and making it less affordable for lower paid workers
- that said in 1919 housing act was passed that allowed government subsidies to local councils to allow the construction of affordable housing
12
Q
the abolition of slums
A
- 1930, gov offered councils a special slum clearance subsidy
- wasn’t successful as by 1933 councils were asked to prepare five year programmes for the abolition of slums
- by 1939 most houses had piped water and were connected to a sewage system
13
Q
George Peabody and housing
A
American banker founded the Peabody Donation Trust with the object of providing model dwellings for the poor
- the first block of 57 dwellings opened in Spitalfields in 1864 and contained water closets for every 2 flats
- by 1939 housing 33,000
14
Q
Titus salt and housing
A
- wealthy Bradford mill owner
- in 1850s moved his factory and workers out of the filthy, polluted environment to the purpose built village of Saltaire
- built up social amenity and laid down strict rules for his workers (e.g. joining unions)
15
Q
Octavia Hill and housing
A
- bought up run down Artisan cottages and renovated them to improve their standard (e.g. connected to sewers and clean water)
- she then let them at low rates to paupers and by the mid 1870s had more than 3000 tenants
- she was a strong believe in self help and was against municipal housing as she thought bought should not become reliant on charity
16
Q
Ebenezer Howard and housing
A
- wrote to-morrow: a peaceful path to real reform in 1898 believing people should live in harmony with nature in towns where there was plenty of green space, light and fresh air. an emphasis on good Public Health
- this started the garden city movement that supported the building of Letchworth. the first garden city in 1903 and the second garden city Welwyn in 1920 (both in Hertfordshire)
17
Q
William Lever and housing
A
- found a new site for his soap making business and had a model village for his workers
- built 800 houses between 1899-1914 with lots of social amenity such as hospitals, schools and concert halls
- he introduced welfare schemes and provided entertainment in a society where there were strict rules on behaviour
- individuals are examples of benevolent patriotism
18
Q
background for vaccinations
A
- smallpox has been a controllable disease since Jenner’s discovery of the vaccine in 1798
- national vaccine establishment was set up in 1808, using a government grant to promote vaccination
- until the mid 1830s due to cost and anti-vac movement, used by the well to do but only intermittently
- in the days before Pasteur’s discovery of the germ theory of disease and without antiseptics and an understanding of the need to sterilise needles, things could go wrong
- dangers of unvaccinated population were demonstrated by smallpox epidemic 1837-40 in which 42,000 people died
19
Q
vaccination acts
A
- permissive vaccination act 1840 meant nobody could be vaccinated free of charge by the poor law medical officers
- compulsory vaccination act 1853 made it obligatory for parents to have their children vaccinated for smallpox within three months of birth. If parents failed to comply, they were fined £1 and money went towards the poor rate. this made them ore common bu they were administered in a haphazard way.
- 1870-73 epidemic where 44,000 people died resulted in a more draconian act
- the compulsory vaccination act 1871 made it obligatory for local boards of health to appoint vaccination officers and imposed a fine of 25 shillings on parents who refused to have their children vaccinated. imprisonment for those who didn’t pay the fine
20
Q
drawbacks of vaccinations and how were they dealt
A
- emphasis on compulsion led to a groundswell of opposition and a strong anti-vac movement
- argument ranged from fear of central go interference to religious objections about injecting impurities into the blood
- fears were somewhat ameliorated by 1898 by the insertion of a conscious clause in the SmallpoxAct and by the end of the year over 200,000 exemption certificates were granted
- in 1875, only 3.8% of all registered births in England and Wales were of unvaccinated babies, by 1898 it had risen to 26.6%
- despite the lack of take up, death rate continued to fall
- showed that cooperation with local gov was needed
21
Q
vaccination - Leicester
A
- deaths from smallpox fell without the vaccination
- infected people were compulsorily quarantined
- disinfecting the houses of the quarantined people and where necessary burning their bedding and clothing
- Leicester anti-vac league was formed in 1869and together with the London Society for the Abolition of compulsory vaccination carried out a determined campaign against the compulsion of central government
- encouraged other towns to form their own anti-vaccination leagues and a demonstration held in Leicester in 1885 had representatives from over 50 towns
- the Leicester method gran in popularity with other towns such as Huddersfield getting private acts of parliament to make quarantining compulsory
22
Q
medical officers of health
A
central government might devise codes of practice and local authorities form boards of health or sanitary committees, but the effectiveness of such matters was dependent on the appointment of a qualified medical officer
- most town councillors were elected on the promise of keeping rates low creating inevitable tension
- the constitution of many councils tended to skew any decision towards maintaining the status quo
- tight oligarchies were difficult to persuade to spend money on unseen development like drains as oppose to more obvious elements of civic pride like town halls
- change in attitudes happened at different rates for different places
23
Q
examples of successful medical officers
A
- Dr William Henry Duncan was appointment as Liverpool’s medical officer in 1847
- was a man of considerable standing in the medical profession and it regular correspondence with Edwin Chadwick
- the fact that such a man could take such an interest in public health was a signal to other local authorities of its importance
- John Simon was a medical officer of health for the city of London providing ample evidence of the importance
24
Q
did other areas quickly follow the example of medical officers?
A
- Leeds didn’t appoint one until 1866 and Wolverhampton no full time one 1921
- in 1875 when it became obligatory, there were approximately 50 medical officers of health holding down full time appointments
- low pay meant that they had to take other jobs and so weren’t fully committed
- the uncertain tenure meant that weren’t going to be too rigorous as they could be removed at whim by the authorities. did guarantee they weren’t too lax however
