The limitations to Chadwick’s work was his argumentative and arrogant character which antagonised people and made it difficult for him to get people to support his case. Another limitation to his work was that his 1842 report did not lead to an immediate reform. The Public Health Act was introduced in 1848 and this did not force councils to improve public health, yet it simply suggested what councils should do. Moreover, his influence faded in the 1850s as he retired in 1854 and played no part in advising the government after this.
On the other hand, Chadwick was not the only individual who had an impact on improving public health systems. After 1837 all births, deaths and marriages had to be registered and William Farr used this information to build an accurate picture of where the death rate was the highest and what people died of. This proved the link between the high death-rate and unhealthy living conditions. Therefore Farr’s evidence put pressure on local and national governments to make changes. Furthermore, in 1849 John Snow published a book saying that the cholera spread through water, not ‘bad air’. In 1854 another cholera outbreak gave him the chance to prove his theory. Snow decided to map out the deaths in detail around his surgery and write a report detailing his evidence. Snows evidence was so strong that the handle of the Broad Street water pump was taken away, stopping people from getting water from the pump. There were no more deaths. It was later discovered that a cesspool was leaking into the drinking water. Snow had proved that clean water was essential for preventing the spread of cholera but even this did not lead too much of a change as many scientist still believed in the miasma theory. Joseph Bazalgette designed and built the London’s sewage system after the Great Stink of 1858. Bazalgette realised that the population was forecast to grow so he made sure the sewers had a much higher capacity that was needed in the 1860s.
I think that chance was an important factor in improving medicine as the timing of the 1848 Public Health Act was the result of the latest epidemic of cholera. As cholera spread across Europe in 1847 fear grew in Britain of many thousands of death were to come. Therefore the government finally followed Chadwick’s recommendations and passed the Public Health Act in the hope this would reduce the impact of cholera. However, the 1848 Act was not compulsory. Only 103 towns set up local Boards of Health. Many more did not, and the National Board of Health, set up to oversee reforms, was abolished after only six years in 1854.
I believe that Chadwick’s role in improving public health services in towns in the nineteenth century was sufficiently important as without his report on the Sanitary Conditions of the Labouring Population, the public health act in 1848 may not have been set up. Although this was an important factor, it was not the only influence in public health therefore his role was not vital yet it did help the process of improving the public health standard.