Bad water supplies, inadequate drains, damp houses, and indifference to rubbish all helped spread disease. In the 1830’ a civil servant called Edwin Chadwick was employed by the Poor Law Commission. After Chadwick’s report in which he concluded that much poverty was due to ill health caused by the foul conditions in which people lived, and that the best way to improve anything was to improve their health. However, Edwin’s recommendations posed a problem for the government. The government knew that if they tried to force the local councils to follow the recommendations, it would be unacceptable. However, in 1848, faced by the second epidemic of cholera, Parliament reluctantly approved the public health act of 1848. This encouraged local authorities to improve conditions in their area. Moreover, the cost of improving public health was very expensive, and only a few local authorities started to take measures. Conversely, six years later the government’s board o f health was disbanded to the delight of critics. (Medicine and Health through time book)
The Great Stink was a time in the summer of 1858 during which the smell of untreated sewage almost plagued people in central London, England. Prior to the Great Stink there were over 200,000 cesspits in London. Emptying one cesspit cost a shilling - a sum the average London citizen then could ill afford. As a result, most cesspits added to the air-borne stench. Part of the problem was due to the introduction of flush toilets, replacing the chamber-pots that most Londoners had used. These radically increased the volume of water and waste that was now poured into existing cesspits. These often overflowed into street drains originally designed to cope with rainwater, but now also used to carry outfalls from factories. In 1858, the summer was unusually hot. The Thames and many of its urban tributaries were overflowing with sewage; the warm weather encouraged bacteria to thrive and the resulting smell was so overwhelming that it affected the work of the House of Commons and the law courts. Heavy rain finally broke the hot and humid summer and the immediate crisis ended. However, a House of Commons select committee was appointed to report on the Stink and recommend how to put an end to the problem. Therefore, the great stink of 1858 forced many people not to enjoy public health, because the horrid smell was so nasty many people were forced to stay inside. Once again it was only until Bazalgette’s sewer network after the great stink that the smell was relieved. Before the 1900’s, it seemed that it was only after there had been the epidemic and disease, that people started to act. They never thought about these problems before the epidemic and disease.(Internet- wikipedia)
Joseph Bazalgette, who was a chief engineer of London's Metropolitan Board of Works, was the creation of a sewer network for central London, which helped relieve the city from cholera epidemics, while beginning the clean-up of the River Thames, which had reached a all-time low with "The Great Stink" of 1858. In 1858, the year of the Great Stink, Parliament passed an enabling act, in spite of the huge expense of the project, and Bazalgette's proposals to transform London's sewerage system began to be implemented. The expectation was that enclosed sewers would remove the stink, and this then reduced the occurrence of cholera. Bazalgette's solution was to construct 83 miles of underground brick main sewers to intercept sewage outflows, and 1,100 miles of street sewers, to intercept the raw sewage which up until then flowed freely through the streets and thoroughfares of London. The outflows were diverted downstream where they were dumped, untreated, into the Thames. The effect of the new sewer system was to reduce cholera not only in places that no longer stank, but wherever water supplies ceased to be contaminated by sewage. (Internet- wikipedia)
Despite all progress in science and in public health in the nineteenth century, infant mortality was worse than it had been in 1801. The main cause for the problem was poverty leading to malnourishment. This was because millions of people who could not afford even to give their children proper food, much less to pay doctors bills. Diarrhoea caught from germs was the main cause of deaths of young babies. Other infectious diseases were also very serious. Infant mortality was higher in poor families, who were living in insanitary and badly ventilated housing, or eating a poor diet. Colds were also a cause of infant mortality. Furthermore, overcrowded housing was the most important contribution to the spread of preventable disease. Octavia Hill was a Philanthropist, concerned with the welfare of the inhabitants of cities, specifically London, in the second half of the 19th century. Malnourishment was also a key factor to why nobody enjoyed public health, because people were being starved. (Medicine and Health through time book) (Internet)
Conversely, after 1900 there were many changes to public health. The First World War brought about great improvements. X-rays were invented before the war. During the war their use became routine to find bullets and shrapnel lodged in the body. Furthermore, blood transfusion was used effectively for the first time, Methods of storing blood and transporting it to where it was needed was improved. In addition, the soldiers who fought in the war were promised good housing when they returned- ‘home for heroes’, this speeded up the process of getting rid of unhealthy slum housing in Britain. Faced by hundreds of thousands of casualties surgeons learned fast. They developed new techniques to repair broken bones; they also improved methods of grafting skin which later formed the basis for plastic surgery. In addition they improved surgery of the eye, ear, nose and throat. What’s more, they successfully attempted brain surgery. (Medicine and Health through time book)
Furthermore, one of the biggest questions asked in the twentieth century was, ‘why did infant mortality decrease so rapidly?’ The government started to take measure between 1902- 1930, they made it compulsory for midwifes to be trained, meals had to be provided for school children, all births were to be notified to a health visitor, schools were to provide medical care and checks, overcrowded housing was to be banned and building regulations were to take place. Additionally, local authorities were to provide health visitors, clinics for pregnant women and infants, and to provide day nurseries. Local authorities were also told to build new houses for the working classes. Finally, in 1930 a five year slum clearance programme began. In 1900 when the army needed recruits for the Boer war, it was found that 38% of volunteers were unfit to be soldiers. The government was so alarmed by the army recruitment problem that it set up a committee on physical deterioration to find out why. (Medicine and Health through time book)
Charles Booth was an English philanthropist and social researcher. His work documented working class life in London at the end of the 19th century, work that along with that of Benjamin Seebohm Rowntree influenced government intervention against poverty in the early 20th century. Booth investigated poverty in London working with a team of investigators. This research, which looked at incidences of poor people in the East End of London, showed that 35% were living in abject poverty. He then invented the idea of a 'poverty line', which he set at 10 to 20 shillings for a family of 4 or 5 people. The poverty line shows when an individual might find themselves above or below the 'poverty line'- an idea Seebohm Rowntree developed from Charles Booth; the poverty line Rowntree drew has the age of the individual along the bottom, showing main events in the person’s life that would effect whether or not they were above or below the poverty line. These events include getting married; their children beginning to earn; when the children leave home and marry; finally when the individual is below the age where they can work. The three main areas on the line where the individual is said to be below the poverty line are from the ages 5-15, 30-40, and 65+. In Rowntree's work, he surveyed poor families in York and drew a poverty line in terms of a minimum weekly sum of money "necessary to enable families... to secure the necessaries of a healthy life". The money needed for this survival level of life covered fuel and light, rent, food, clothing, and household and personal items, adjusted according to family size. He determined this level using scientific methods which hadn’t been applied to the study of poverty before. According to this measure, 27.84 percent of the total population of York lived below the poverty line.
During the 1906 General Election campaign none of the parties made poverty an election issue and no promises were made to introduce welfare reforms. Despite this the Liberals led by Henry Campbell-Bannerman won a landslide victory and began introducing wide ranging reforms. There were many reasons for the liberal reforms. The writings of Booth and Rowntree helped change attitudes towards the causes of poverty. Booth carried out extensive research into the poor living conditions and poverty experienced in London, whilst Rowntree made a social investigation into the problems experienced by the poor in York. These investigations provided statistical evidence for genuine moral concern for the poor. They stated that illness and old age were greater causes of poverty than idleness and moral weakness. Rowntree was himself a close friend of Lloyd George, after the two met in 1907 after Lloyd George became President of the Board of Trade. Rowntree himself hoped that his proposals could influence Liberal policy. The threat from the emerging Labour Party. Socialism was an increasingly popular ideology; if the Liberals did not put forward popular policies, they were in danger of losing votes and handing the House of Commons to the Conservatives. The condition of soldiers during the Boer War was considered unacceptable. The British government had trouble enlisting enough able-bodied recruits to the British army. The emergence of public works schemes set up to improve living conditions which were often run by the Liberals raised the possibility that such schemes could occur on a national scale. The Liberal reforms were funded by David Lloyd George passing his controversial People's Budget which heavily taxed the rich in order to pay for welfare solutions for the poor. The budget met opposition in the House of Lords and passed with a Parliament Act to limit the powers of the Lords over the Commons. The crisis led to the Liberals losing their majority in the House of Commons and relying on the support of the small number of Labour and Irish nationalist MPs .Lloyd George argued that his budget would eliminate poverty, while trying to get the Act passed he gave this speech outlining his reasons for supporting the reforms: "This is a war Budget. It is for raising money to wage implacable warfare against poverty and squalidness. I cannot help hoping and believing that before this generation has passed away, we shall have advanced a great step towards that good time, when poverty, and the wretchedness and human degradation which always follows in its camp, will be as remote to the people of this country as the wolves which once infested its forests".(Internet- wikipedia)
The Second World War created a direct path to the setting up of the National Health Service in Britain. In the early 1900’s the government became increasingly aware of the health problems facing ordinary people. There was still data showing that the poor still lived in terrible housing, and that when they were sick they could not afford medical care. In 1911 the government introduced a National Health Insurance scheme. Workers and their employer made weekly contributions to a central fund which was then used to give the workers sickness benefits, and free medical care from a doctor, if they became ill. However, it was limited to those who were employed. Therefore, this means that children and women were not covered by any insurance scheme. Furthermore, during the economic depression of the 1930’s, it became even harder for people to get good medical care. There were alarming statistics to show that some places, most affected by the depression face a climb in infant mortality again. However, with the outbreak of the Second World War in 1939, the government knew that there had to be medical services to deal with the large numbers of people in need of help. Therefore, in 1939 the emergency hospital scheme started, it was funded and run by the government. By 1942 people were beginning to think about the organisation when the war ended. William Beveridge has an idea about ‘free national health service’ as part of a whole knew insurance scheme. In 1944, the government proposed a free health service; by 1946 the NHS act provided a free health-care system. By 1948, it was the first day of the NHS; there was the nationalisation of the hospitals, the creation of health care centres, a better distribution of doctor’s around the country and a new salary for doctors. By 1944 the system was being planned into two senses, the first that all people could be treated and the second that all forms of health care could be given to the patients. In 1945 a new labour government was elected, and in 1946 its bill to introduce a NHS was passed by parliament.
In conclusion, from the points I have discussed before and after 1900, I can clearly see how people would have enjoyed public health after 1900, from the establishing of the national health insurance from the impact of William Beveridge and Aneurin Bevan. Before the 1900, there was a total lack of knowledge before germ theory, there were many epidemics of cholera, there was the impact of Laissez-Faire, furthermore there was the failure of the 1848 Public health act. They also made it compulsory to have a vaccination in 1853, which many people opposed. There was also the Great stink of 1858 which many people faced problems with, although Bazalgette’s sewer network controlled the problem. On the other hand, after the 1900, the surveys of both Booth and Rowntree provided necessary data for them to find out where major pauperism was coming from. Furthermore, the impact of Lloyd George and the liberal social reforms, in 1906 the liberal government began the creation of the welfare state. Additionally, the most important factor in the twentieth century is the NHS act, which allowed poor people to have free medical care of any sort. The act was also reliable because there had been many great advances from the first and second world wars, where blood transfusion, X-rays and other surgery was greatly improved, making the medical care in the twentieth century more unfailing for the patients. All of these factors, convinced people to enjoy public health more in the twentieth century than before the 1900’s.
