When the first report was published in 1844, it upheld Chadwick’s findings. The second report in 1845 contained proposals for future legalisation, and included a long memorandum from Chadwick explaining the recommendations on sewage drainage and water supply. It recommended that central government be given extensive powers to inspect and supervise local sanitary districts and be given powers to raise money for sanitary schemes through local rates.
Three public health bills came before parliament in 1840 though Chadwick considered them insufficiently far reaching, they failed to gain sufficient parliamentary support and failed to move the public people. The public continued to approve of laissez- faire and believed it was an infringement of civil liberties for the government to intervene on matters of sanitation. Therefore, in 1844 Chadwick set about a propaganda campaign to raise public awareness of the issues surrounding public health part of which was the Health of Towns Association. This part of Chadwick’s role in securing the necessary support for public health legislation was significant as it raised awareness of the problems, putting more pressure on the government to act.
The real breakthrough was in 1848 the new Liberal government finally passed the Public Health Act, Chadwick was appointed Sanitation Commissioner and worked on improving sanitary conditions but many attempts made for further public health reform were blocked. In 1854, Lord Palmerston was appointed Home Secretary and although a supporter of Public Health reform, asked Chadwick to resign knowing that his unpopularity would prevent the Board of Health being strengthened whilst he was in charge. Chadwick agreed in order to keep intact the reforms already passed.
Chadwick’s personality was his success and his undoing: he was persistent in pushing a reform by all available means until action was taken, but he was overbearing and unresponsive to the views of others. With no faculty for accommodating differences of opinion, he failed as a practical politician, notwithstanding his ability as a political analyst. Because of his unpopularity with the public and the government; he was tactless, single minded and fanatical; there were even public demonstrations against him in 1837. He was unable to play a significant role and it was the cholera epidemics of 1831, 1848 1853 and of 1866 that were the building blocks, which provoked government action, rather than the result of Chadwick’s actions. The 62,000 deaths in the 1848 epidemic resulted in a loss in the labour workforce, which then aptly affected business and the economy, which forced the government to intervene. The Times in 1832 stated that ‘Cholera is the best of all sanitary reformers’.
The extent of the achievements of the 1848 Public Health Act was limited due to its restrictions; it was permissive; the bill was described by Henrique’s as an ‘enabling act, with few teeth’ because whether improvements mentioned in the act were carried out in a particular town, were entirely dependant upon local initiative. There were sometimes too many problems to encounter before a local authority could adopt the act and although it did have some victory The General Board of Health it set up was abolished in the 1858 Public Health Act. The 1858 Public Health Act came about as a even more acceptable way of controlling public health alternatively to Chadwick’s Board of Health. This Act, which had been set up partially to alter some of Chadwick’s work was in fact more successful and marked. For the first time central government became involved in the administration of public health in the localities. In this case, government support was gained almost in spite of Chadwick rather than because of him.
Central government first put their full support behind public health legislation with The Sanitary Act, when for the first time an act of parliament dealing with public health was made compulsory. The man who gained government support for this act was John Simon a medical officer of Health to the City of London. By working with the current of local opinion, he achieved more than Chadwick had done by bullying any outright opposition. Since the act, which he influenced, was more successful and the way in which he influenced it more popular, it could be argued that he played a more significant role in gaining support for public health legislation in the nineteenth century than Chadwick. Simon worked within the ‘permissive framework’ set up by the 1848 Act, lobbying local authorities to accept public health systems. Simon was much more open-minded than Chadwick and accepted in some situations that it was impossible to win and backed down. He was able to convince local authorities of his way of thinking and consequently much pressure on the government for progress came from the local authorities themselves. Some historians believe that as a direct outcome of his advice in his annual report of 1865, parliament passed a new sanitary act.
The role of Joseph Bazelgette could also be seen as one of more significance than Chadwick. Bazelgette was the chief engineer of London’s Metropolitan Board of Works which supervised and unified London’s public works. When during the hot summer of 1858 the ‘Great Stink’ overwhelmed all those living near the Thames, including parliament, the Metropolitan Board began work on sewer and by 1866 London was connected to a sewer network, with one exception; the East End. When this was, the only area ravaged by cholera in 1866 people began to accept that change was needed and the impetus for reform came about. Bazelgette convinced the government that introducing public health reform, even if it involved spending money, would improve the lives of ordinary people and lead to the city of London becoming a source of pride. The change in attitude of the government and public also led to greater moves being made towards democracy in 1867, when it was noted that the government needed to listen more to the view of the electorate.
Although the work of other pioneers was important Chadwick had a number of constraints and therefore his ability to play a significant role in gaining support for public health legislation was limited. State intervention between 1830 and 1970 was restrictive and cautious, rather than confident and compulsory. While it is crucial to recognise how limited state intervention was in this period and what an uphill battle ‘centralisers’ such as Edwin Chadwick had, the mechanism of state bureaucracy had inserted a slow-burning fuse into the system. There were a number of obstacles to public health reform, some of which surrounded the debate over the power that local or central authorities should have over the individual independence of people especially when these liberties had to be sacrificed for the common good.
The inspirational ideas of utilitarian philosophers such as Bentham proved to be very important in swaying the government. Along with the laissez-faire attitude of the government, the power of vested interests had an impact on the amount of support that public health reform gained. Because many of the epidemics seen in Britain before the cholera epidemic in 1831/32 were ‘poor mans disease’ such as typhus, rich people were unwilling to pay taxes to the government for public health provision which didn’t benefit them. As many aristocratic people paid to have a separate water supply their own sewerage removal, increasing rates to pay for all houses to be supplied would mean these people paying twice. The government therefore did not readily give support to introducing public health legislation, as they were aware that the rise in taxes would pose problems with much opposition. In addition, many of the people who were able to influence the government’s decisions had vested interests themselves and did not want taxes to rise. They therefore used their position of power to place obstacles in the way of legislation being passed. Chadwick’s role was weakened by the united front that local councils, often in the hands of vested interests, held against centralisation, meaning that there was much objection against legislation similar to the 1848 Act.
In conclusion, how important was Chadwicks role in contributing to public health legislation in the 19th century? The reports, which Chadwick contributed to, were largely triumphant due to his nature of perseverance and the attention to detail he paid to all his work. Chadwick persevered in his work against cholera and the Boards of Health set up after the 1848/49 epidemics lasted long after those epidemics. Consequently, his meticulousness and accuracy ensured he was in a good position to make a considerable input to securing government backing for public health legislation. His research left the government with no other option than to believe his findings and take action. Each of Chadwick’s reports lead on to further investigation.
Chadwick was pensioned off in 1854, which meant he had little influence from this time on and was unable to play a part in public health reform. The work of Simon and Bazelgette in fact led to reform that was more effective and some of Chadwick’s achievements were undone in the 1858 Public Health Act. Chadwick can be credited for initiating and providing impetus for others to continue his work in the campaign for reform. There was a significant change in government attitudes from when Chadwick was working to 1875, this contributed greatly to the process of public health reform, culminating in an important Public Health Act 1875 which had a long lasting impact.
Overall, Chadwick played a crucial role in securing government support; although he was unable to secure the legislation himself, he was the instigator of an intial process of which others were able to work on and develop. The contribution of others may seem more because of the legislation passed in their time. In Chadwicks time there were more political obstacles, a lack of medical knowledge and many vested interests to conquer. Therefore it would be difficult, for Chadwick to gain full support for government intervention regarding public health, the work of others later on in the century was necessary.
