Public Health in Britain➡️1800-1914

Question 1

Describe Bazalgette’s sewers (1859) and how effective they were.

Answer 1

• Bazalgette was given £3 million to clean water➡️Invested in 5 brick- lined sewers which connected 82 miles and pumping stations.
• Bazalgette designed sewers which took into account predicted population figures, optimised flow and were self-cleaning.
• Made Thames one of the cleanest rivers in the world, sewer system still used today and Bazalgette created a blueprint for effective sanitary conditions.

Question 2

Why were improvements to public health necessary in the 19^th Century?

Answer 2

• Water supply (Thames) was contaminated➡️Diseases such as cholera were rife.
• Lack of housing➡️Overcrowded, back-to-back terraced housing➡️People living in wet cellars with animals (e.g: pigs).
• Open cesspits in streets and few toilets➡️E.g: Parliment Street= 1 toilet for 380 inhabitants.
• Rapid population increase➡️Poor infrastructure e.g: waste disposal, housing & water provision.
• Poor people couldn’t afford to live in good conditions and get doctors.

Question 3

What changes were made to public health between 1875 and 1900?

Answer 3

• 1876➡️Building regulations.
• 1876 Rivers Pollution Prevention Act➡️Designed to stop factories and other businesses from dumping their waste in rivers which provided drinking water (only made compulsory 20^thC).
• 1888 Port Sunlight➡️One of the first ‘model villages’.
• 1889➡️Isolation hospitals for infectious diseases.
• 1890s Bournville➡️Another model village.

Question 4

Why was Bournville considered a ‘model village’?

Answer 4

Provided good homes for workers at the nearby Cadbury’s factory➡️1895= 143 cottages built with large gardens, not overshadowed and with running water➡️1/10 of Bournville estate kept for use as parks, recreational grounds and open space and sport facilities also provided.

Question 5

How did Edwin Chadwick affect Public Health in Britain?

Answer 5

• Employed by Poor Law Commission to report on living conditions and health of poor➡️His report concluded much poverty was due to ill health caused by foul conditions and the best way of reducing the cost to the ratepayer of looking after the poor was to improve their health.
• To improve people’s health he suggested providing adequate drainage, removing rubbish from the streets, improving water supplies and appointing a district medical officer with special qualifications.
• Local ratepayers resisted Chadwick’s improvements➡️Govt. reluctantly passed voluntary Public Health Act 1848 but by 1872 only 50 councils had appointed medical officers and in 1854 the Board of Health was disbanded.

Question 6

What was the 1909 budget proposed by Lloyd George and how was it changed to form the 1910 budget?

Answer 6

• 1909➡️Raised tax on tobacco and spirits.
• 1909➡️Raised income tax by 16%.
• 1909➡️Introduced a new 20% tax on profits from selling land.
• 1909➡️The House of Lords refused to agree to the tax increases.
• 1910➡️The land tax was dropped and the budget accepted in 1910.

Question 7

What did Charles Booth do?

Answer 7

• In 1885 Booth became angry about the claim made by Hyndman of the Social Democratic Federation that 25% of Londoners lived in poverty.
• After investigating this ‘pauperism’ Booth published his first volume of the Life and Labour of the People of London in 1889 which suggested that 35% rather than 25% were living in poverty.
• Booth expanded his research to cover all of London, producing 17 volumes of work. Amongst his conclusions were that Old Age Pensions were necessary.

Question 8

What were the for and against views on national insurance?

Answer 8

✅A vital safety net to tide people over hard times.

❌Poor people had to pay the contributions out of their wages, dole and sickness pay only lasted for a limited time, and the money given was not enough to live off.

Question 9

What are the themes in the public health course?

Answer 9

• Causation➡️Causes of public health reforms, causes of lack of reforms.
• Effectiveness➡️How effective each reform was.
• Varying pace➡️The speed of how things develop.
• Significance➡️How much reforms impacted, whether it’s a turning point in public health.
• Changing nature➡️How the focus of public health changed.
• Opposition➡️Why and when people opposed reforms.

Question 10

What changes to public health were made between 1800 and 1860?

Answer 10

• 1802+ Factory Act(s)➡️Improved people’s working conditions.
• 1834➡️Poor Law Amendment Act.
• 1848 Public Health Act➡️Set up a Board of Health and gave towns the rights to appoint a Medical Officer (voluntary).
• 1853➡️Vaccination against smallpox made compulsory.
• 1854➡️Improvements in hospital hygiene introduced (thanks to in large part Florence Nightingale).
• 1855 Nuisance Removal Act➡️Introduced sanitary inspectors after 1853-4 cholera outbreak.

Question 11

How did John Snow affect Public Health in Britain?

Answer 11

• In 1854 Snow investigated a cholera outbreak in Soho➡️He interviewed local residents and plotted a dot map of deaths.
• Snow found that those who died had all drunk from the same water pump on Broad Street➡️His dot map convinced the local council to remove the pump handle and deaths stopped in the area.
• However, no other action was taken to improve public health because Snow couldn’t explain his findings so without explanation and strong supporting evidence the government was reluctant to change public health on the basis of Snow’s findings.

Question 12

How did lack of knowledge limit improvements to public health?

Answer 12

At the beginning of the 19^thC people understood the link between dirt and disease but were still unaware that germs caused disease➡️This meant people didn’t understand it was necessary to improve conditions as they didn’t understand that germs in the poor conditions was causing illness and costing businesses money as a result of sickness.

Question 13

What were the for and against views on labour exchanges?

Answer 13

✅By 1914, 1 million people were being employed through the labour exchange.

❌Most of these jobs were temporary or part-time; the government didn’t do anything to increase the number of jobs available.

Question 14

What were the for and against views on free medical treatments?

Answer 14

✅Literally a life-saver.

❌Only for the wage earners- it was not available to their wife or children.

Question 15

What were the for and against views on free school meals?

Answer 15

✅By 1914 150,000 children were getting one good meal a day.

❌Not compulsory so some councils didn’t provide free meals.

Question 16

How did Joseph Chamberlain improve the situation in Birmingham?

Answer 16

• Chamberlain used Artisan Dwelling Act to buy 50acres of property to build new road, Corporation Street, through Birmingham’s overcrowded slums➡️Death rate in Corporation Street decreased dramatically.
• Chamberlain forcibly purchased both gas companies on behalf of the borough to ensure the companies were no longer competing with each other➡️Ownership of the two main gas companies gave the city much greater control over what happened in the city and reduced inconvenience.
• Chamberlain forcibly purchased Birmingham’s waterworks➡️Dug 6 wells in and around the city to provide 20 million imperial gallons per day.

Question 17

What changes were made to public health between 1860 and 1875?

Answer 17

• 1866 Sanitary Act➡️Made local authorities responsible for sewers, water and street cleaning.
• 1867 Reform Act➡️Gave the vote to large numbers of working-class men who could elect politicians sympathetic to their needs like public health.
• 1870+ Local authorities set up schools➡️Health education taught and improved literacy made it possible for people to read pamphlets on advice from Medical Officers.
• 1875 Public Health Act➡️Enforced laws about slum clearance, provision of sewers and clean water and removal of nuisances.
• 1875 Food & Drugs Act➡️Made the ‘adulteration’ of food or drugs a criminal offence, improving quality of food.
• 1875 Artisan Dwelling Act➡️Allowed local authorities to buy and demolish slums if they were not kept well (voluntary).

Question 18

What problems were there in Birmingham before Joseph Chamberlain?

Answer 18

• Much of the housing in Birmingham was of poor quality and many industrial workers were living in slums➡️Life expectancy in these areas was poor.
• Two gas companies in Birmingham- Birmingham Gas and Staffordshire Gas- were in constant competition with each other➡️They were continually digging up streets to lay new gas mains which caused great inconvenience for people in city.
• Approx. half of population dependent on well water, much of which was polluted with sewage➡️Water supply considered a danger to public health.

Question 19

What was the ‘dirty party’ and how did it limit improvements to public health?

Answer 19

This was a group of MPs set up to oppose reforms to public health. They felt that living in filth was fine and a matter of choice. They did not see why rich people should pay for poor people➡️This meant it was hard to get any reforms passed as they would be voted against by a large number of Tory MPs who did not want the government to take responsibility for what should be done (in their opinions) by individuals.

Question 20

What changes were made to public health between 1906 and 1912?

Answer 20

• 1906 Provision of School Meals Act➡️Government permitts local authorities to provide school meals.
• 1907 School Medical Inspectors➡️Compulsory medical inspections in which the checks were free but treatment was not.
• 1908 Old Age Pensions Act➡️People over 70 given between 1 and 5s. a week, only if they earnt under 12s.
• 1909 Labour Exchanges➡️Helping the unemployed find paid employment.
• 1911-12 National Insurance Act➡️Wage earners paid in, in return recieved free medical attention and medicine and guaranteed 7s. a week for 15 weeks a year if they became unemployed.
• 1912 School Clinics Act➡️Provides free treatment to young people.

Question 21

How did the Great Stink cause improvements to public health?

Answer 21

• In the summer of 1858 there was a heat wave in London➡️Poor sewer systems and overcrowding combined with high temperatures=air of London filled with pungent aroma of human waste.
• It was so bad that MPs refused to attend Parliment and this forced them to take action➡️The River Thames was dredged and Parliment commissioned designs for a new sewage system.

Question 22

What were the for and against views on pensions?

Answer 22

✅Kept many old people out of the workhouse.

❌Was refused to people who had never worked in their life.

Question 23

What does ‘self interest’ mean and how did it limit improvements in public health?

Answer 23

Many Middle-Class believed that because they lived in houses with basic sanitation, the problems of the cities were nothing to do with them➡️This meant that many people who did have the vote did not see there was a problem with public health so did not believe there was any need to change or pass reforms.

Question 24

How did voting and the government limit improvements to public health?

Answer 24

UK governments in the 1800s were elected by only men who either owned land or earned a certain amount of money a year➡️This meant that the governments ignored the wishes of the working classes because they could do so and not lose their power, they only needed to please the Middle-Class so public health reforms were unlikely.

Question 25

Why was Port Sunlight considered a ‘model village’?

Answer 25

Provided good homes for workers at nearby soap factory➡️Cottages had leaded windows, their own running water and indoor bathrooms➡️1909= 700 cottages, gymnasium and open air swimming pool.

Question 26

Who was Lloyd George hated and loved by?

Answer 26

❤️Old people celebrated and blessed Lloyd George.

😡Many workers hated paying National Insurance.

Question 27

What does ‘self help’ mean and how did it limit improvements in public health?

Answer 27

This was a belief popular in the Middle-Class that giving anything to anyone for free would make them less likely to look after themselves➡️This meant that people paying taxes thought using taxes to pay for public health improvements would lead to people being lazy and expecting something for nothing.

Question 28

What does ‘laissez-faire’ mean and how did this attitude limit public health improvement?

Answer 28

This was the government view that some things, like public health care, were not their job and they felt to force any changes would be against what governments did➡️This meant that the government was unlikely to pass new reforms and when they did it was often voluntary (e.g: Public Health Act 1848).

Question 29

What did Seebohm Rowntree do?

Answer 29

• Rowntree’s father carried out major surveys of poverty in Britain, inspiring Seebohm to investigate poverty in York.
• He found that poverty was either primary (due to earnings being insufficient) or secondary (earnings sufficient but money mispent on things such as alcohol).
• Rowntree became close friends with Lloyd George who introduced a series of reforms influenced by Rowntree, including Old Age Pensions and National Insurance.

Question 30

Why did the demands for reform continue to grow in the 20^th Century?

Answer 30

• Boer War➡️Recruits were rejected en masse due to poor physical health.
• National efficiency➡️Fears that Britain was in decline as a world power led to the idea that Britain had to improve its national efficiency by improving the quality of the workforce.
• Social reformers➡️Social reformers such as Charles Booth and Seebohm Rowntree carried out research into the living condition of the poor.
• German model➡️The example of Bismark’s progressive social legislation in Germany coupled with her economic and military strength impressed Lloyd George and Churchill.

Question 31

Why were the Liberal reforms of 1906 to 1914 important?

Answer 31

They marked a change in government policy from a largely laissez-faire approach to a more ‘collectivist’ approach.