Unit 3.2 Changes in Public Health (COMPLETE)

Question 1

What were the successes of Edward Jenner’s smallpox vaccine?

Answer 1

• In 1798, Jenner was given £30,000 to set up a vaccine clinic in London.
• Over 100 leading doctors supported his research and declared their intention to vaccinate.
• It became difficult to get life insurance, a job or rent a room without a vaccination.
• Vaccinations made compulsory in 1853.
• Permissive vaccination act meant people could be vaccinated free of charge.
• Death rate from small pox began to drop significantly.

Question 2

What were the failures of Edward Jenner’s Small Pox vaccine?

Answer 2

• Jenner submitted his findings to the Royal Society who refused to publish them as Jenner couldn’t explain how it worked.
• Leicester had a popular anti-vaccination movement and the ‘Leicester Method’ of combatting small pox grew in popularity.
• In 1870-1873 there was a 2nd small pox epidemic with 44,000 mortalities.
• Parents could be fined and imprisoned upon refusal to vaccinate their children.
• By 1898, 203,145 exemption certificates were created (Parents in Lancashire accounted for over 1/3rd of applications)
• Religious beliefs suggested that the vaccine interfered with divine timing.
• By 1900 there were still thousands of unvaccinated babies.

Question 3

What did the Vaccination Act of 1853 impose?

Answer 3

• A £1 fine if parents didn’t vaccinate children within 3 months of birth.
• This money went towards the Poor Rate.
• This made the vaccination more common, but it was administered in a haphazard way.

Question 4

What did the Vaccination Act of 1871 impose?

Answer 4

• Motivated by the second Small Pox epidemic in 1870.
• Made it obligatory for local boards of health to appoint vaccination officers.
• Imposed a fine of 25s on parents who refused to have their children vaccinated.
• Failure to pay fine resulted in imprisonment.

Question 5

What was the significance of Tuberculosis?

Answer 5

• Biggest 19th century killer.
• TB killed more people each year than smallpox, scarlet fever, measles, whooping cough and typhus put together.
• Due to it being a respiratory disease it spread most rapidly in overcrowded, poorly ventilated conditions and was most prevalent amongst the working classes.

Question 6

What actions did local officers of health take to combat TB in Oldham?

Answer 6

• Local medical officer of health ordered the leafleting of houses stressing that TB was highly infectious.
• It forbade spitting in public.
• Advised the burning of all handkerchiefs used by sufferers.
• Stated that the local authority would disinfect all houses lived in by TB sufferers.

Question 7

What actions did local officers of health take to combat TB in Brighton?

Answer 7

• Issued similar leaflets to that of Oldham.
• Urged people to only spit in bowls provided for that purpose.

Question 8

What preventative measure was issued in 1922 in response to TB?

Answer 8

• Ministry of Health ordered the pasteurisation of milk.
• This prevented the spread of TB from cattle to humans.
• • This measure had to be put into action and monitored at a local level.

Question 9

What happened in 1934 in response to TB?

Answer 9

• An Act was passed empowering local authorities to make milk free, or subsidised, pasteurised milk available to school children.
• By 1937 school milk was being provided for 3.7 million children.

Question 10

What was considered to be the most effective ‘cure’ for TB after WW2?

Answer 10

• Fresh air, sunlight ,good food and rest
• A considerable effort went into the provision of sanatoria where the focus was on these treatments.

Question 11

How many sanatoria were there is 1911 and 1930?

Answer 11

• In 1911, there were 84 sanatoria providing 8000 beds.
• -By 1930, this had risen to 500 sanatoria and 25,000 beds.
• Despite this, surgery for glands, bones and joints affected by TB was common and in 1910 accounted for 1/6 of all surgical operations.

Question 12

What was the 1906 Education (Provision of Meals) Act and what was the Result?

Answer 12

1. Liberal government Act allowed local authorities to use public money to provide free school meals for children of parents-in-need.
2. Significant step for public health: children were portrayed as the responsibility of the state and not just their parent.

• However the attitudes of people to supporting those ‘in need’ remained hostile.

Question 13

What was the 1907 Education (Administrative Provisions) Act and what was the Result?

Answer 13

1. Act set up a school medical inspection service and subsequently a treatment service.

• Grants became available for local authorities to establish school clinics and school nurses.
• Local authorities were encouraged to make their local medical officer of health and their school medical officers the same person.
• 2) In the early 20th century, school medical service expanded considerably.
• By 1935, there were 2300 doctors and 5300 nurses involved in school medical care.
• However, some authorities ignored the conditions of the Act.

Question 14

What was the 1908 Children and Young Person’s Act and what was the Result?

Answer 14

1. This act was bought about after serious lobbying by the NSPCC.

• The Act made it legal to prosecute parents for neglect or cruelty.
• Children’s homes were subject to inspection.
• Pubs were forbidden to let children under 14 inside.
• Shopkeepers were forbidden to sell cigarettes to under 16s.
• Juvenile courts were set up to separate child and adult offenders.
• 2) Act represented a radically new relationship between the state, parents and children.
• Children started to have their own ‘rights’.

Question 15

How did WW1 impact housing improvements?

Answer 15

• House building stopped altogether.
• House repairs were minimal.
• Returning soldiers found that Lloyd George’s promise to clear slums was hollow.
• Dramatic rise in the cost of building matters made it impossible to build houses that low paid workers could afford.

Question 16

What changes were made to housing in the 1920s-1930s?

Answer 16

• Government offered councils a special slum clearance subsidy to encourage councils to pull down slums and rehouse their inhabitants at rents they could afford.
• By 1939, most houses in towns and cities had piped water and were connected to a sewerage system but only 50% had a hot water tap and fixed bath.

Question 17

What was the 1842 City of Leeds Improvement Act?

Answer 17

• Local Government.
• Gives municipal authorities some control over new buildings, sewer connections and cellar dwellings.

Question 18

What was the 1844 Metropolitan Building Act?

Answer 18

• Local government.
• Required all newly constructed buildings that were within 30ft of a common sewer to be connected to it.

Question 19

What was the 1868 Artisans and Labourer’s Dwellings Act (Torrens Act)?

Answer 19

• Local/National government.
• Gave local councils the power to force a landlord to repair an insanitary house.
• If landlord failed to act the council could buy it and pull it down.

Question 20

What was the 1875 Artisans and Labourer’s Dwellings Improvement Act (Cross’s Act)?

Answer 20

• Local/NationalGovernment.
• Gave local councils the power to clear whole districts not just individual houses.

Question 21

Who was Titus Salt (1803-1876)?

Answer 21

• Wealthy Bradford mill owner.
• In the 1850s moved his factory and its workers out of a filthy polluted environment to the purpose-built village of Saltaire.
• Built a new mill, houses, a school, park, almshouses and a hospital for his workers.
• However, imposed strict conditions for his workers.

Question 22

Who was Octavia Hill (1838-1912)?

Answer 22

• Renovated cottages (repaired, cleaned, decorated and connected to sewers)
• Let these renovated cottages out for low rent.
• By the mid 1870s, Hill had over 3000 tenants.
• However she only did this because she was a firm believer in the ‘self help’ philosophy.

Question 23

Who was William Lever (1851-1925)?

Answer 23

• Found a new site for his soap-making business and alongside had a model village built for his workers.
• Between 1899 & 1914 some 800 houses were built at Port Sunlight.

Question 24

What were the successes of Local Government initiatives in improving the health of the public?

Answer 24

• Initially, local government intervention was more prominent, series of acts would be applied locally not nationally.
• Pioneering work was done in certain towns and cities.
• Thomas Perceval and John Ferriar of Manchester were behind the formation of the Manchester Board of Health in 1785.
• In Scotland, Robert Graham, Robert Cowan and James Cleland published reports in the early 19th century which prompted authorities to act.

Question 25

What were the limitations of Local Government initiatives in improving the health of the public?

Answer 25

* Local individual action was only piecemeal and only applied locally. * By the 1830s town improvement committees were beginning b to be seen as corrupt. * Various groups of officials became self-perpetuating oligarchies with vested interests.

Question 26

What were the successes of the Medical Officers of Health in improving the health of the public?

Answer 26

* 1875 Public Health Act made it compulsory for all authorities to appoint someone in charge of public health (medical officer). * Medical Officers were usually trained as doctors or surgeons. * Both William Henry Dunant (Liverpools MO) & John Simon (Londons MO) were very successful. * Compulsory MOs from 1875. * After 1888 medical officers had to be fully qualified. * Public health was normalised in local governments & elections.

Question 27

What were the limitations of the Medical Officers of Health in improving the health of the public?

Answer 27

* Most local councillors chosen as they promised to keep public health rates low - middle class councillors weren't convinced about spending tax payers money on public health. * Medical officers were poorly paid so it was seen as a ‘second job’ * 1875 legislation was poorly implemented.

Question 28

How significant was the work of Individuals in improving Public Health, c1780-1939? EDWARD JENNER

Answer 28

* Jenner repapered his vaccination experiment with 23 patients, none of whom caught small pox. * Self-published his results in 1798, which led to over 100 leading doctors supporting his research & declaring their intention to vaccinate. * Parliament gave him £30,000 to establish a vaccination clinic in London. * Despite all his support vaccination dandy sweep the country. * Jenner couldn't get the Royal society to publish his findings as he couldn't explain how they worked. * Many of the people within the Royal Society were making income from inoculation and were reluctant to change.

Question 29

How significant was the work of Individuals in improving Public Health, c1780-1939? What did they Do? What was the Significance? EDWIN CHADWICK

Answer 29

1. In 1842, wrote a report on the link between poverty and public health. * Concluded that spending money on public health would save the poor. * Involved in the Poor Law Commission. * Helped contribute towards the 1848 Public Health Act. * 2) Used his position to persuade the government to take action. * However, was seen as a bully, was a controversial figure and no actual action was made in response to his recommendations.

Question 30

How significant was the work of Individuals in improving Public Health, c1780-1939? What did they Do? What was the Significance? MARIE STOPES

Answer 30

1. In her book ‘Married Love’ she was strongly against abortion but recommended contraception. * Advise initially provided to middle-class women but later included working-class women. * 2) Opened a women's clinic in London which provided advice and are still around today. * However, faced lots of objection, wasn't supported by parliament, no legislation was passed and lots of the working class were illiterate.

Question 31

How significant was the work of Individuals in improving Public Health, c1780-1939? What did they Do? What was the Significance? JOHN SNOW

Answer 31

1. Discovered that Cholera was water-borne. * Not many believed him as they believed in miasma. * Found a vast amount of evidence linking a water pump in Broad Street to the disease, once the pump was taken away death rates fell. * 2) Proved rear diseases could be spread through water. * Made John Simon (Chief MO) abandon attachment to miasma theory. * However, John Simon did a larger study of London. * It wasn't until 1870 when Snows theory was fully accepted. * People didn't agree with his theory at first.

Question 32

How significant was the work of Individuals in improving Public Health, c1780-1939? What did they Do? What was the Significance? JOSEPH BAZALGETTE

Answer 32

1. Built new sewer system in London. * Put all waste into rivers and sea. * Acted in response to the great stink * 2) Responding to political demand for change. * Asked to carry out work by government shows an ending in laissez faire. * Disproved the theory of miasma. * Got the Royal Seal of approval. * However, struggled with funding prior to the great stink. * Didn't treat the sewer, just moved it.