A) Evaluate, with clear references to evidence, the nature of urban public health problems in the 18th and early 19th centuries.
Urban public health had many problems in the 18th and 19th century. One of the contributions to the poor health of the 18th century was the sale and consumption of gin. It was linked with the high death rate in London and so a national campaign to have gin banned was started. The most high profile marketing campaign against gin was from the engraver Hogarth who portrayed the sale and consumption of gin as the fall of humanity. By looking at both engravings Gin Lane and Beer Street, it is clear that Hogarth clearly thought the consumption of beer was the backbone of Britain and would steer the British public out of its health problems. (Source 3 see appendix) In 1736, an act was passed that virtually banned the sale of gin. However there was a public outcry and the government were soon forced to back down. They changed their tactics and in 1751 raised the prices and limited the places gin was available to buy. This soon had an impact and the mortality rate of London began to improve.
Another of the main problems that can be seen is the lack of basic cleanliness on the streets of urban areas. Up until 1858, there was no sewerage system, London and many other cities had no real way of dealing with the public waste. The only system used were the dung heaps and the local businessmen often ran these. The businessmen would sell this to the local farmers for fertilizer. By looking at source B (Tonge and Quincey pg 5-6) we can see that Dr Reid’s visit to the people of Newcastle had horrified him. He explained in depth that the landlords and farmers were unwilling to cease the practice of selling and purchasing of dung heaps as it meant a source of income for the poor was lost. He also explained that the local people had poor knowledge of disease and the fact that they did not consider the dung heaps a contributing factor towards the poor heath of the area.
Dr Reid was greatly concerned for the morality and health of the poor. He explained that the living conditions were some of the worst within the city. If we compare this to John Houghton, Esq., we can also see that that the surgeon looked at the conditions in the same way yet the earnings of the two different areas are completely different. (Wolverhampton University original unknown). Dudley is part of the Black Country and the majority of inhabitants would have migrated there for the iron works industry which was a growing economy. (Map B see appendix). This influx of workers meant that living conditions were overcrowded and cramped. Newcastle did not have such an influx of people and therefore did not suffer with the same magnitude of problems. The earning potential would have been greater in Dudley yet the standard of living was probably worse.
B) Explain what contemporaries meant in the early 19th century when they referred to “laissez faire” and “interference”
Because of the poor standard of living and cramped conditions, cholera began to gain momentum in epidemic proportions. In 1831, the board of health gave a description of the symptoms of cholera and this was reprinted by the Sunderland newspaper. As a Port, it would have been the most likely place a disease would start and spread. The town council felt that to protect its citizens, it would place various regulations and notices up offering advice as to how to deal with cholera (Parker and Reid pg 108). One of the biggest examples of interference that can be seen is the example of the local government placing the port into quarantine. This was done on the information received by a Mr Kell, (Tonge and Quincey pg 22-29).
He had reported the first few cases of cholera in Sunderland. As the port had been placed in quarantine there was general uproar with the local sea traders and businessmen. They held a meeting on the 11th of November 1831 (Tonge and Quincey pg 22-29) to attempt to have the quarantine lifted. They argued that cholera had not arrived to Sunderland via the ports. They felt that the interference by the local council was unnecessary and actually causing more harm than good. This is a perfect example of “laissez faire” attitude. Another example of the “laissez faire” attitude is seen in the letter from Lord Londonderry. (Tonge and Quincey op cit pages 22-29) The letter had been written to a London newspaper but was reprinted in the Sunderland Herald. He writes to convince the readers that the claims of cholera in Sunderland had been greatly over exaggerated and possibly false. Lord Londonderry was a very influential man in the northeast and the prevention of trade movement would have had a large effect on his own businesses. He was very much in favour in leaving things alone and allowing business to continue despite the apparent outbreak of cholera.
C) Analyse the barriers which lay in the way of reform of public health in the first half of the 19th century.
It is surprising to see that public health took a long time to advance. However, there were many reasons for the lack of reform in public health. Many of the water companies that existed at this time were privately owned, and the new developments in water supply and sewerage systems were very costly. The private water companies felt that by improving the systems it would add to the responsibilities and costs. Another example of the lack of reform, were the landlords. The legislation put forward would force them to provide water supply and sewage systems, again a costly and time-consuming exercise, which did not appeal to the landlords. In order to change the public health, the money would have to come from the taxpayer and the majority of the ratepayers were local businessmen and landlords.
Many of these ratepayers were unable to see that by advancing the public health it would actually benefit them. Local governments would also prevent the move for public health moving forwards. A good visual example of this can be seen from the drawing in source Q (Longmate 43) we can see from the drawing that the pigs represent the resistance from a local level. The pigs can be seen to be wearing glasses, as if to show the short sightedness of the local level government regarding the changes needed in public health. We can also see that the pigs are wallowing in mud, which is more than likely a reference to the lack of cleanliness on the city streets. The gentleman in the middle is Lord Morpeth who is holding a number of sanitation bills. He was the man who campaigned and eventually got the first public health act through to parliament. Punch is seen in the right of the drawing, and was a character that represented the ordinary people. He can be seen to be holding his nose almost to say “we need reform”.
D) Discuss the influences which led to a shift towards reform of living conditions by the late 1840’s.
The Sanitary Condition of the Labouring Population produced by Edwin Chadwick, showed results that by improving the quality of water supply and sewage systems, would in turn improve the health of the poor. It showed that the charges for sickness and mortality would decrease and therefore decrease the current ratepayer’s charges. Chadwick’s mentor Jeremy Bentham was a great believer in Utilanarisim. “the greatest happiness of the greatest number” and Chadwick himself believed in this same idea. This was his main argument for the move towards change in public health. Another influence was brought in by William Farr. In 1837, the legislation of marriages, deaths and births were to be recorded by law. With this change in legislation came a way of monitoring the public health. It could be seen exactly where cholera outbreaks occurred and how often. With this statistical information, it helped towards Chadwick’s own reports towards reform of public health. Another possible shift towards reform would have been the fear of Chartism, This charter called for voting by ballot by every working man in Britain, annual parliaments and many other ideas. In order to keep the public happy and prevent this Chartism from gathering pace public health reform was drafted in to keep the public happy.
E) Assess the view that the public health act of 1848, was a limited response to the need for reform.
The Public Health Act of 1848 was originally set out for just 10 years as a response to Chadwick’s report on sanitation. The time constraint on the act was a limit in itself to the response to reform. However, the main limit on the health act was the fact it was not compulsory to comply with at a local level. Local Governments could pass by-laws if they felt that it did not suit the local area. Under the terms of the 1848 Public Health Act, only 13 of the 182 local boards built sewerage and waterworks. It is also possible to see that although local governments passed by-laws to escape some requirements of the health act it also encouraged some to actually set up their own local board of health. Some local boards even became competitive! The need for reform and the response to the public health reform invited debate within the country that had not been seen at this scale previously.
Source B: Cholera and Public Health, Neil Tonge and Michael Quincey, Page 5-6 Macmillan, 1985
Source E: Wolverhampton University, Original Unknown.
Source L: The British Revolution 1750-1970, M St J Parker and D J Reid Page 108, Blandford, 1972
Source Oiii: : Cholera and Public Health, Neil Tonge and Michael Quincey, Page 22-29 Macmillan, 1985
Source Oiv: Cholera and Public Health, Neil Tonge and Michael Quincey, Page 22-29 Macmillan, 1985
Source Ov: : Cholera and Public Health, Neil Tonge and Michael Quincey, Page 22-29 Macmillan, 1985
Source Q: Welcome Historical and Medical Museum Library, quoted in Norman Longmate, “Alive and Well” Page 42, Penguin 1970