Public Health Act 1848 and the General Board of Health

Need for sanitary reform

The Public Health Act 1848 received royal assent on 31 August 1848, 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.

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.

Boards of health

The Public Health Act 1848 established the General Board of Health, which was responsible for advising on public health matters such as epidemics and disease prevention. It was also empowered with establishing and managing local boards of health.

The General Board of Health was set up for a provisional 5 year period. 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 7 years); and in areas where 10% of ratepayers petitioned for one.

In 1851, the General Board of Health issued a statement on the duties and responsibilities of local officers of health (appointed by local boards of health, subject to the approval of the General Board of Health). These duties included giving instructions and directing the removal or prevention of the causes of widespread diseases.

Boards became responsible for removing 'nuisances' from streets such as refuse or bad paving. They were also responsible for drainage and water supply, as well as other sanitary actions. Officers were required to report quarterly to the General Board of Health, providing information on illnesses and deaths in their areas and provide more detailed information in an annual report, including recommended actions. 

Centralisation of power

Though it was the first move towards formalising state responsibility for protecting the health of the public, 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'.

The opposition was considered to originate from those with 'vested interests', who feared the loss of personal freedoms or represented business interests.

Later developments

The General Board of Health was reconstituted on an annual basis until 1858, when its functions were transferred to the Privy Council, a council of advisers to the sovereign, primarily comprised of senior members of the House of Commons or Lords. The council was given powers that included having a say in the selection of medical professionals by parishes and poor law unions.

They were also able to direct how funding allocated to vaccinations should be spent. Additionally, they were able to commission inquiries into public health matters. The Privy Council could appoint medical officers, who would annually report to the Council on public health matters.

In 1971, the Local Government Board Act established the Local Government Board, which took over the public health work of the Medical Department of the Privy Council.