Public Health Its not just drains and sewers

Public Health (It’s not just drains and sewers!)

The Industrial Revolution n The late 18 th century saw a rise in the country’s population. Towns and cities grew quickly. . . So living conditions worsened. There was also an ability to create and work with chemicals, which would lead to progress.

Causes of Illness in Industrial Towns n n n n Overcrowding Pollution Poor quality housing Damp Vermin Lack of clean water Lack of sewers – filthy streets n Remember that poor working conditions and poor diet made people less resistant to illness.

Why was there no reform? n n n Towns and cities developed quickly, with little planning. Landlords and businessmen wanted to make profits quickly, and weren’t interested in people’s welfare. There was a laissez-faire attitude – the government didn’t interfere in people’s business or lives. Better off people did not want to pay for improvements for the poor. Working class people did not have a vote and their needs were not considered. Poverty was thought of as something to be accepted and endured.

So why was the 1848 Public Health Act passed? n n The Liberal Party came to power. . . They were slightly more interested in reform than the Conservative (Tory) Party. The Chartists had put pressure on the government. They showed that working people were interested in politics. The report of Edwin Chadwick. .

Edwin Chadwick n n n He was not concerned about the welfare of the poor, but that poor health and high death rate was costing the country money. He published his Report on the Sanitary Conditions of the Labouring Classes in 1842. He showed that the poor living conditions were the cause of the high death rate. He said that each town should have an arterial water system – water piped to houses, and sewers. He said that each town should have a medical officer.

1848 Public Health Act n n This said that sewers and clean water had to be supplied to all towns where the death rate was above the national average, or where 1/10 of the ratepayers chose it. Towns had to appoint a Medical Officer of Health.

John Snow n n n In 1854, another cholera epidemic broke out in London. Dr Snow examined the handle of the Broad Street pump, and replaced it. He mapped the deaths of people from cholera in the Broad Street area. He showed the connection between contaminated water and disease. When he replaced the handle, the epidemic stopped.

Why was the 1875 Public Health Act passed? n n n The 1848 Act had not gone far enough – it did not apply to all towns. Many towns still had high death rates from the unsolved problems. There were repeated outbreaks of cholera. Pasteur’s Germ Theory showed how disease was spread. An Act of 1867 gave working men the vote. They could put pressure on the government to clean up the towns.

By 1900. . . n n n The problem of sewage in the streets and dirty water had been solved, but. . . Problems of slum housing, poor wages, poor diet and inability to afford medical treatment were still major threats to health. In 1909, back to back houses were banned across the country, but some housing was still poor.

The Welfare State n n n 1906 Free school meals were provided for the poorest children. 1908 Old age pensions were started. 1911 National Health Insurance was provided – a compulsory insurance scheme for poorer workers. It allowed them to draw sick benefit and see a doctor when they were ill. Note that the Liberal Government was in power. It did not treat poverty as a crime. By this time the Labour Party had been formed. Although only small, it represented the workers in Parliament.

Council Housing n n n After the First World War, the government said it would provide ‘homes fit for heroes’. Council houses were built from the 1920 s, to provide a decent standard of housing. After 1930, many slum houses were pulled down in the towns and cities, and were replaced with council houses.

By the 1930 s. . . n n People still suffered poverty due to poor wages and unemployment. The 1930 s was a time of Depression. Many families could not afford a good diet. They could still not afford a doctor (the 1911 Act only covered the wage earner). . So poor health remained a serious problem, especially among mothers and children.

The Beveridge Report n n n This was produced in 1942 by William Beveridge, a civil servant. He said that there were serious threats to quality of life, including poverty and squalor. This report was vital in setting up the NHS. . .

Bevan and the NHS n n In 1946, the NHS was introduced by Bevan, a Labour MP. The NHS was to be available to everyone, free at point of service, and paid through taxes. Need was to be the only criteria. The NHS opened its doors in 1948.

Why was the NHS set up? n n The Labour government was in power. The 1911 Health Insurance clearly did not go far enough. The war had shown the poverty that some families were still living in. There was a sense that the people deserved better, having suffered in the war.

Who opposed the NHS? n n n Many doctors, because. . They did not want to have their wages or schedules controlled by the government. Many did not want to treat the poor and the dirty. n n n Many better off people and Conservative MPs because. . . The NHS was to be funded through taxes. They didn’t want to be paying for someone else. They thought the system would be taken for granted, and it would make people dependent.

A never ending story? n n There are plenty of examples of ways in which the government intervenes to improve our health and welfare e. g. Food standards Environmental health and pollution control Education campaigns (e. g. smoking, drugs, healthy lifestyle).