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Unlock This CourseThe Public Health Act of 1848 had been a weak law. Councils could set up a local Board of Health only if the death rate was above 23 per 1,000 or if a tenth of ratepayers asked. Many councils did nothing. Most people in power still believed in laissez-faire: the government should leave people alone, and clean water and sewers were not its job. Ratepayers (people who paid local taxes) also hated paying for them.
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By the 1870s four things had pushed people to think differently.
In the hot summer of 1858 the River Thames, full of sewage from London, smelled so foul that Parliament was hard to use. MPs hung curtains soaked in chemicals at the windows. This time the problem hit the people who made the laws. Within weeks Parliament agreed to pay for new sewers.
Joseph Bazalgette, chief engineer of London's Metropolitan Board of Works, built a new system of sewers in the 1860s. They carried waste away from central London to outfalls further east, down the river. London's last big cholera outbreak was in 1866, in the East End, which the new system had not yet fully reached. This seemed to show that sewers made towns safer.
Snow's work in 1854 linked cholera to dirty water, and Pasteur's germ theory of 1861 made people more interested in germs. The old idea that bad smells (miasma) caused disease was becoming less certain, so clean water and sewers made more sense.
The Second Reform Act of 1867 gave the vote to many working men in towns. They lived in the dirtiest, most crowded streets. Politicians now needed their votes, so health reform became worth promising.
In 1872 an earlier Act had split the country into sanitary districts, each with a medical officer of health. The Conservative government of Benjamin Disraeli then brought in the big law of 1875.
The Public Health Act of 1875 pulled earlier laws, including the 1872 Act, together into one clear code. Local authorities now had to:
Councils also had powers, which they could choose to use, such as building public parks and baths. The Local Government Board in London watched over the work.
The 1848 Act said councils could act. The 1875 Act said they must. That change from voluntary to compulsory is why the 1875 Act is seen as a turning point in public health.
It applied to councils whether or not they asked for it, and it made officials whose job was health a normal part of local government. It stayed the basis of public health law for many decades, until a new Act in 1936. In the story of medicine since 1848 it shows a change of attitude: the government had started to accept that protecting health was its duty. How well it worked in the following decades is a separate story.
Change and continuity: the law changed from voluntary to compulsory, but cities were still dirty and crowded for years. Not every council acted quickly, and doctors still did not know the cause of many diseases.
Explain two ways in which the Public Health Act of 1875 was different from the Public Health Act of 1848. [6 marks]
Remember: one way on its own can score no more than half marks. For each way, give a fact about both Acts.
One difference was that the 1848 Act was voluntary, whereas the 1875 Act was compulsory. In 1848 a town only had to set up a Board of Health if its death rate was above 23 per 1,000 or a tenth of ratepayers asked, so many councils did nothing. In 1875 every local authority had to provide water, drains and sewers.
A second difference was that the 1875 Act made councils appoint health officials. Under the 1848 Act a Board of Health could appoint a medical officer, but few did. Under the 1875 code every sanitary district had to have a medical officer of health and a sanitary inspector, so someone was always responsible for checking on the town's health.
What lifts this to the top level: each way compares both Acts directly with a specific fact on each side.
For a "different from" question, use the words "whereas" or "but in 1875" so that both sides of the comparison sit in the same paragraph.