Public Health: Phase 3 The beginning of public health 1860-1900

Question 1

What was the Great Stink

Answer 1

In 1858, extremely hot weather and the low level of the River Thames exposed sewage along its banks. The smell was so bad that parliament couldn’t meet even though sheets of disinfectant were covered up at the windows to help with the smell.

Question 2

How did Bazalgette solve the problem of the Great Stink?

Answer 2

MPs passed an Act (within 18 days) to provide money for a new sewer system

Bazalgette was chosen to design it and £3 million was given to the London Metropolitan Board of Works.

His plans included:

• The sewers would be very large and built of brick. Sewage would be less likely to get stuck in oval tunnels.
• The whole system planned to bring waste down to the lower stretches of the Thames where the river was tidal and it would be swept out to see

The whole project was expensive and took several years to complete. Most of the 2000km of sewers had been built by 1865.

They mainly used gravity to keep the sewage flowing but also built 4 pumping stations between 1864-1875 and two treatment works to deal with sewage not sent out to sea.

By 1875 the whole project had cost £6.5 million.

When the sewers first opened, a small railway was installed so people could travel through it - they could even buy souvenirs.

Question 3

What other reasons were attitudes starting to change in order to lead to the 1875 Public Health Act?

Answer 3

• Parliament became convinced they should take action to improve public health. In 1852 and 1871, laws were passed making smallpox vaccination compulsory for children. and the 1866 Sanitary Act said that all towns had to employ medical inspectors.
• Snow’s work in 1854 seemed to prove a link between water and cholera.
• Pasteur’s germ theory showed how disease was spread.
• The government started collecting statistics on birth, marriages and deaths; William Farr studied these and showed that death rates were higher in towns and cities than villages
• An outbreak of cholera in 1866 least affected towns where there had been improvements in public health
• In 1866, Leeds appointed a medical officer, had a pressure group to force the council to make changes and had sewage purification works. Manchester made regulations about the size of rooms and windows in new houses. Towns began to compete with each other to be the cleanest.
• When working class men got the vote in 1867, they used their voice to put pressure on the government. In the 1870s, Mayor Joseph Chamberlain of Birmingham carried out several reforms including the demolition of 40 slums.
• From 1870 every local authority had to set up schools. Health education was taught and improved literacy meant people could read medical pamphlets.
• In 1875 the Artisans Dwelling Act gave local authorities the power to buy and demolish slum housing.

Question 4

What was the 1875 Public Health Act?

Answer 4

It was largely seen as a mechanism for consolidating the previous Acts of Parliament relating to public health from the 19th Century.

The act established name local authorities as rural and urban sanitary authorities, replacing the old boards of health.

Authorities were obliged to provide clean water, dispose of sewage and refuse and ensure that only safe food was sold. The act forbade the building of homes without connection to a main sewage system.

In short:

• Clean water
• Public toilets
• Rubbish removal
• Sewers and drains
• The Act also made towns appoint Health and Sanitary Inspectors and a Medical Officer of Health

Question 5

What other Acts of Parliament were there in the 19th Century?

Answer 5

1875 Artisans Dwelling Act - gave local authorities the power to demolish slum housing

1875 Food and Drugs Act tried to improve the standard of food being solved. Dangerous malpractices were common e.g shopkeepers would mix flour with sand to make it weigh more.

1876 River Pollution Prevention Act made it illegal for factories to put their waste into rivers

1889 Infectious Diseases Act ordered householders of doctors in London to report cases of infectious diseases to the Medical Health officer. It was extended to the rest of the country in 1899 and led to new isolation hospitals.

Question 6

What other improvements were made in the 19th Century?

Answer 6

• Park Hospital opened in 1897. It had 48 wards for scarlet fever, 24 wards for diphtheria and fever and isolation wards for highly contagious diseases.
• Joseph Chamberlain (Mayor of Birmingham) bought the companies that provided water and gas light and provided these for the city. He cleared 40 acres of slum housing.
• The Cadbury’s family in Birmingham built a village for their workers (Bournville). It was a model community with good housing, parks, sports facilities, schools and community buildings.
• Titus Salt built Saltaire for his workers near Bradford. It had 800 houses, piped gas, water and toilets. It had parks, a hospital and other facilities for the workers.
• The Lever family near Liverpool built a village for their workers called Port Sunlight. It had decent housing, parks, schools, art galleries and other community buildings.

Question 7

What were the limitations to change during the 19th Century?

Answer 7

In many towns, basic services such as water, lighting and paving were still in the hands of individuals and private companies.

Many people still lived in appalling poverty and ill health. General standards of health remained poor.

Studies by Charles Booth and Seebohm Rowntree showed that large numbers of people lived below the poverty line in conditions where disease spread quickly.

Poverty meant poor nutrition, which affected people’s health and death during childhood was common

From 1881, infant mortality started to increase again

There was no comprehensive system to improve public health by tackling its causes - poverty.