The Public Health Act 1848 received royal assent following extensive debate on the poor sanitary conditions in Britain. However, the catalyst for reform was the anxiety caused by a new cholera epidemic sweeping Europe (Fee and Brown, 2005). The act’s provisions were based on the findings and recommendations made by Edwin Chadwick in his Report on the sanitary conditions of the labouring population of Great Britain.
The act created a new, central General Board of Health, a provisional body which would be responsible for advising on epidemics and disease prevention. The board had responsibility for local boards of health; however, it had no power to compel them to implement the provisions of the act.
Local boards of health were set up in non-corporate towns: areas with high death rates (of an average mortality rate of 23 out of 1,000 people over a period of seven years); and in areas where 10% of ratepayers petitioned for one. Local boards of health became responsible for removing ‘nuisances’ from streets such as refuse or bad paving, and for drainage and water supply, as well as other sanitary actions. The local boards were also empowered to appoint officers of health (subject to the approval of the General Board of Health) and inspectors of nuisances (forerunners to the modern day environmental health officers).
Though it was the first move towards formalising state responsibility for protecting the health of the public (Mclean, 2005), the act gave local boards rights to make conditions sanitary, but there were no legal obligations to do so. Coupled with this, there were ongoing concerns raised about the centralisation of power, as the act’s provisions ran contrary to the government’s laissez faire philosophy and ‘evoked a nightmare of socialist dictatorship riddled with jobbery’ (Mclean, 2005). The opposition was considered to originate from those with ‘vested interests’ (Fee and Brown, 2005) who feared the loss of personal freedoms or represented business interests.