Tuesday, 29 April 2008

Public health: Introduction

Poor housing, overcrowding and high levels of disease, often held to have been exacerbated by the massive influx of Irish migrants, were certainly perceived as problems by those with power and authority in the Victorian city and by politicians at Westminster. Despite prevailing laissez faire[1] attitudes, the development of municipal intervention in various aspects of the urban environment reveals a genuine crisis in urban living conditions with an increasing gap between public expectations and the realities of urban life.  Much as they might have wished to, neither local nor national politicians could ignore urban living conditions:

  1. The increasing amount of statistical and other information was discussed and publicised by local societies and used as propaganda by medical men and others with first-hand experience of life in the slums. Edwin Chadwick[2] was the best-known propagandist, but at the local level many influential people became increasingly aware and concerned about conditions of urban life.
  2. Such evidence was unlikely to have been enough on its own to persuade ratepayers and their elected representatives to pass legislation and spend money improving housing and sanitation for the working class. Self-interest was at the heart if political action. Concerned about events in Europe, politicians genuinely believed that poor living conditions could lead to mass disturbances and urban violence.
  3. Closer to home, the impact of cholera in 1832 and 1848 brought home, especially to the middle classes, the fact that disease could affected all classes. The poor were blamed for the disease, but it was in the interests of the middle classes to improve conditions and prevent it recurring. Intervention was also rationalised through economic self-interest since a reduction in disease and improvement in housing would bring about a more efficient workforce and therefore benefit industrialists and entrepreneurs.
  4. But there were also important constraints. The contrast between political reaction to Chadwick's contribution to the Poor Law Report in 1834 and reaction to his 1842 public health report[3] was stark. In 1834 legislation rapidly followed the Report. However, it took six years to produce the public health legislation Chadwick wanted. In 1834 Chadwick was putting into words the commonly held assumptions of a broad spectrum of society, whereas in 1842 he was radical and original. The reasons for the differing response and the delay in legislation were largely to do with the variegated issues raised by the public health question. Derek Fraser synthesised them into four types of factor: technical; financial; ideological; and, political

If things were so bad why did neither central nor local government seem to do anything about it? There are various reasons for this situation. Derek Fraser has identified several but the following points [some of which he makes] need to be examined:

Inefficient local government

Today services like sewage disposal, street lighting and paving is provided by one local authority. Before 1835 many of the growing industrial towns did not have a Royal Charter and therefore did not have a Town Council. Where councils existed they were often corrupt and inefficient; self-perpetuating rather than elected and unaccountable for the ways in which they used the local rates. In some towns power was in the hands of the parish vestry that was elected by property owners.

  • Local government reform occurred with the Municipal Corporations Act 1835. It provided for elections every three years by the ratepayers of the town councils. It also allowed rates to be levied for street lighting, fresh water-supply and sewage disposal but this took a local Act of Parliament.
  • Most towns before 1835 tried to deal with 'nuisances' like water supply and drainage. These were the Improvement Commissions. The problem was that each Commission dealt with a specific area of health not the whole package. There was consequently confusion and lack of co-ordination.
  • The chaotic nature of local government militated against effective reform.

Added to this was self-interest. Various groups in towns acted against any interference with the existing situation:

  1. Water companies and builders were in search of profit. Water companies, for example, only supplied water to those areas of a town where the householders could afford the fees.
  2. Builders exploited the demand for cheap housing and paid little attention to drainage, ventilation or water supply.
  3. Private landlords were reluctant to pay for sanitary improvements largely because of the cost and their reluctance to accept any responsibility for the cleanliness of the working classes.

Ignorance

Knowledge of town planning was limited and this led to jerrybuilt houses. There is also the suggestion that middle class families were ignorant of the real conditions in which the working classes lived. Middle class houses were built on the edge of towns and were worlds apart from the inner-city slums.

Laissez-faire

Whose responsibility was public health? The laissez-faire attitudes of the period meant that central government did not see it as their responsibility and so did nothing.

Whatever the reasons, the second half of the nineteenth century saw unprecedented activity in the passing of both bylaws and national legislation affecting urban living conditions. Local legislation was in practice more important than that passed by the national Parliament: national acts often included what had previously occurred at a local level.

 

Principal public health and housing legislation in Britain 1848-1914

1848 Public Health Act [England and Wales]

1851 Lodging Houses Act [England and Wales] -- Shaftesbury Act

1855 Dwelling Houses Act

1858 Public Health Amendment Act

1866 Sanitary Act

1866 Labouring Classes' Dwelling Act [England and Wales]

1868 Artisans' and Labourers' Dwellings Improvement Act [Torrens Act]

1872 Public Health Act [England and Wales]

1874 Working Men's Dwellings Act [England and Wales]

1875 Public Health Act [England and Wales]

1875 Artisans' and Labourers' Dwellings Improvements Act [Cross Act]

1879/80 Artisans' and Labourers' Dwellings Improvements Act

1882 Artisans' Dwellings Act

1885 Housing of the Working Classes Act

1890 Housing of the Working Classes Act

1890 Public Health Act

Although the Public Health Act 1848 did not effect any major changes in urban areas, it was the culmination of a concerted public health campaign in England and Wales, marking acceptance of the fact that public health was an issue of national importance. Not until the Sanitary Act 1866 were local Authorities obliged to provide a proper water supply, drainage and sewerage system, and even this Act lacked teeth to enforce its powers. Many towns acted independently: Manchester, for instance, took control of the city's water supply in 1851. But powers to force Local Authorities to act to improve water supply and sanitation did not become effective until the 1875 and especially 1890 Public Health Acts.


[1] Laissez-faire comes from the French and roughly translates as ‘let it be’ or ‘leave it alone’. There was an important contemporary debate on what the proper role of the state, locally and nationally, should be. One school argued that there should be a ‘minimal state’ in which the state should intervene in the lives of individuals as little as possible.

[2] R.A. Lewis Edwin Chadwick and the Public Health Movement 1832-1854, Longman, 1952 is an essential work on Chadwick and should be read in conjunction with S.E. Finer The Life and Times of  Sir Edwin Chadwick, Methuen,  1952.  These  should  now  be supplemented  with A. Brundage England's "Prussian  Minister". Edwin Chadwick and  the Politics  of  Government Growth 1832-1854, Pennsylvania  University Press, l988.

[3] Edwin Chadwick Report  on  the Sanitary Condition of the Labouring Population, 1842, new  edition, M.W. Flinn (ed.), 1965.

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