Paste your essay in here… I will be writing up a written account which will describe the origins of the public health in the UK. And I will also be demonstrating knowledge and understanding of the key pioneers, laws, reports and papers. Also I will cover the development from the 19th, 20th century to the end of the 21st century.
19th Century:
Work of John Snow: Snow was a British physician who was considered as one of the founder of epidemiology for the work he did and identifying the source of cholera outbreak in the 1854. John Snow was born in a labourer family on 15th March 1813 in York and at the age of 14 he was apprenticed to a surgeon. In 1936 John Snow moved to London to start his formal medical education. He became a member of the Royal College of Surgeons in 1838 and graduated from the University in 1844 and then he got admitted to the Royal College of Physicians in the 1850s. At this time it was as thought that cholera was airborne but Snow didn't accept this as the bad air theory he argued that it was entered into the body from the mouth he then published his ideas in an essay on the Mode of Communication of Cholera in the 1849. A few years down Snow had been able to prove his theory in the dramatic circumstance. In the 1854 August there was an outbreak of cholera that had occurred in Soho after very careful investigation this included plotting the causes of cholera on the map of the area. Snow was then able to identify that there was a water pump in the Broad now known as the Broad-wick street as the source of the disease. However Snow had the handle of the pump removed and the cases of cholera immediately began to diminish, but Snow's germ theory of disease was widely accepted until the 1860s. John Snow was a pioneer in the field of anaesthetics this was by testing the effects of controlled doses of chloroform on animals and on humans, he made these drugs really safe and more effective. In April 1853 John Snow was responsible for giving chloroform to Queen Victoria at the birth of her son Leopold and performed it again in April 1857 when she gave birth to her daughter Beatrice. On 16th June 1858 John Snow died from a stroke.
Edwin Chadwick: Was born on the 24th January 1800 in Manchester and in 1810 he moved to London with his father who subsequently abandoned him in his young adult years. When he moved to the United States with his second wife and children. He was a clerk in London until he was the age of 23 when he began to pursue law and enrolled in the Inner Temple. He wrote for newspapers to make living during his law studies and the combination of the law and the press had opened his eyes to the social problems of London. This was exactly of the prisons, hospitals and the slums. This interest placed him in circles of Philosophic Radials of the day. John Stuart Mill, Nassau senior and Jeremy Bentham. Edwin Chadwick was very close to Jeremy Bentham and act as his secretary until the philosophes death in 1832. Although he was really close to Bentham he didn’t believe in the populist aspects of the Benthamite movement. Edwin Chadwick was very rational, centralising and administrative and didn’t see the value of individual rights. The views marginalised him from the Philosophical Radicals however he was able to secure a second job as a freelance civil servant after Bentham’s death. It was this position that put Chadwick on the map as a political reformist. 1832 Edwin Chadwick started to work as a secretary with the poor Law Commission he also used his skill’s for investigations and research administration to help the frame reforms in laws aimed at the poor. Edwin Chadwick’s work on the poor law led to a great deal of controversy and was specifically his views on the workhouses. He used to hold very strong views on the workhouse and that the system needs to be imposed however this used to clash with many of those in power. The workhouse system also included laws that would separate men from their wives and parents from their children. Edvin Chadwick seems to lack concern for individual’s liberties and his outspoken views and his brash personality and he became the brunt of the attack against the poor laws waged by the working class. And they also saw the laws as an authoritarian and the over centralized. Edvin Chadwick reforms the sanitation and not only had he transformed the sanitation infrastructure in London but also the lines of thinking of the time. He started to research on the sanitation in the 1839, and this was the same year he married Rachel Dawson and his extensive research on the living conditions of the slums of England that led him to publish the report on the sanitary conditions of the labouring of Great Britain in the 1842. Edwin Chadwick’s writing was concerned with the states control, shifting the blames of poor health on poor sanitary conditions while ignoring other things like the diet and labouring conditions. The administrative slant in Chadwick’s writing led to total revolution in the social thoughts. It has also been established that a link between sanitary conditions and the high mortality rates that show the misery of the poor law within the governments control not in some intrinsic deficiency in the class. His writing also led to Public Health Act of 1848 in which the government began to acknowledge some responsibility for the upholding health of the population. The public health initiative and the board of health and was created and Chadwick was appointed the Commissioner. Through the choleras widespread of 1848-49 Edvin Chadwick ordered a replacement of the traditional brick sewers with his self-flushing and glazed the pipes in the hopes of taking the sewage to farmers for use as compost. This had annoyed many engineers who thought that they might have been overstepping his bounds. In the 1848 in the attempt to get rid of poverty stricken areas of their filth in the drains he had also ordered the sewers of London to be flushed into the Thames this was very devastating and lead to extreme contamination of the Thames with over 20,000 cubic meters of sewage dumped into the Thames and from March to May of the 1848 over 50,000 cubic meters from September to February 1848. He had a very strong opinionated personality with democratic views. He was attacked publically in the House of Commons in 1854 by Benjamin Hall his eventual successor as the commissioner to the board of the health. He attacked both his personality and his career calling him an unscrupulous and dangerous man. In light of this massive loss of the Parliaments support and Edvin Chadwick was forced to resign in 1854.
Even with the many arguments surrounding Chadwick’s work and his life. Edvin Chadwick has also established the essential principles by writing about the poor sanitary conditions that were linked to the poor health. Chadwick had a positive impact on the public health sector. He also died on July 5, 1890 and was buried in Surrey.
The Sanitary Movement: this was an approach to the public health that was first developed in England in the 1830s and 1840s with the increase in the industrialization and urbanization and the removal of the filth from towns and the cities became a major focus in the struggle that was against the infectious disease. As it’s pioneered by Edvin Chadwick and the sanitary movement that has also been embraced as the explicit political objective and according to the urban cleansing took on a figurative as well as a literal sense and this was seen as a potential solution and to the threat that was posed by the dangerous classes. Paris and Naples get on the wholesale rebuilding projects, necessitating the large-scale state interventions. Even though these technological reforms that are marked on an undeniable step forward for the public health and they often are also entailed to the exclusion of the other strategies such as the progressive economic and educational reform.
Poor Law Act (1834): the public health provisions as we know it today originated with the nineteenth-century Poor Law system and the Victorian sanitary reform movement. The Poor Law was amended in the response to the 1832 Royal Commissions of Inquiry into the operation of the Poor Laws. In this report the commissions made several recommendations to the parliament. As a result The Poor Law Amendment Act 1834 was passed which had stated that no able bodied individual was able to receive money or any sort of help from the Poor Law authorities except in the workhouse. The conditions in the workhouses were to be made very harshness to discourage individuals wanting to receive help. Despite its harshness the act did ensure that the poor were housed, clothed and fed and if any children who entered the workhouse would receive some sort of schooling. In return for this care all workhouse paupers had to work for several hours a days.
First Public Health Act (1848) Industrialisation and the rapid growth of cities was during the nineteenth century had led to concerns about environmental problems this was like housing, water supplies being unclean, bad air and the impact that these had on the health of the working population. Edwin Chadwick who was an founding member of the sanitary movement was the active campaign on several public health issues these included poor housing, working conditions and sanitary reform. In Chadwick's report on the inquiry into the sanitary conditions of the labouring population of Great Britain 1842 had contained a mass of evidence that was linked to environmental facts, ill health and poverty. It was then recommended that there was an establishment of an single local authority that was supported by the expert medical and civil engineering advice then to administer all of the sanitary matters. After six years the national Public Health Act (1848) was passed and the first Board of Health was established.
20th Century:
Beveridge Report (1942): Just after the Second World War there was a strong feeling for the British people that they should be rewarded for their sacrifice and resolution. The government then promised to reform that would be creating a more equal society. So they asked Sir William Beveridge to write a report on the best way that they can help individuals who are on low incomes. However in December 1942, Beveridge published a report which was proposing that all individuals at working age have to pay a weekly contribution which would go toward the benefit and would be paid to those individuals who were either sick, unemployed, retired or widowed.
Founding of the National Health Service (1948): After the aftermath of the Second World War Clement Atlee's Labour Government created the NHS this was based on the proposals of the Beveridge report A 1944 an white paper debate was then followed by other considerable debates with the resistance organised by the BMA which stands for British Medical Association. But the structure of the NHS in England and Wales established by the National Health Service Act 1946 and there was new arrangements which were set in 5th July 1948 these were under the health and housing minister Aneurin Bevan. The founding principle of the NHS called for it to be funded out of the general taxation and not through national insurance. The NHS services were provided by the same doctors and the same hospitals however the services were provided free at the point of use, financed from central taxation and everyone that was eligible for the care even those who were temporarily residents or visiting the country.
Acheson Report (1998): In the July 1999 Donald Acheson was told to review inequalities in health in England and was asked to identify priority areas for development of policies to reduce them. This was followed by two earlier famous reports in this field the report of Sir Douglas Black in 1980 and the updated version from 1987 The Health Divide. Both of these report have been kept really quiet because of the bleak picture that was painted of widening health inequality in such an developed country and that the implications for the government of the day. Donald Acheson had concluded his report with an list of 39 recommendations and for addressing health inequality. There were three areas in which it was identified as crucial to this process are that all policies are likely to have an impact on health and that they should be evaluated in the terms of their impact on the health inequality, there should be given a high priority of health of families with children and there should be further steps taken to reduce income inequalities and to improve the living standards of poor households.
Our Healthier Nation (1999): This was an health strategy that was released by the Labour Government shortly after it came to power in 1977. it had clear links with the Acheson Report that was proposing to tackle the root causes of ill health, air pollution, low wages, unemployment, crime, poor housing. It was focused on the prevention of the main killers this was like cancer, coronary heart disease and stroke also accidents and mental illnesses.
21st Century:
White paper (Choosing Health: Making healthier choices easier (2004): the white paper recognised that the interest in health was increasing and was recommended that there was a new approach to the public health. Reflecting rapidly and changing increasingly technological society. The paper acknowledges that the government’s role in promoting social justice and tackling the wider causes of ill health and inequality as well as recognising the needs to empower individuals to change their own lives. The strategy set out in the document has three principles which are informed choices, personalisation this is the support that is tailored to the needs of individuals and working together with all real progress which depends on the effective partners across communities. The main priorities were to reduce the number of individuals who smoke, reduce obesity and improve nutrition, increases exercise, encourages and support to sensible drinking, improving sexual health and improves mental health. Also the public health paper sets out areas for actions these are children and young people by 2010 all schools in England should have active travel plans this is a plan that is put together by the school which shows how it will encourage active forms of transport this is like cycling as opposed to travel by car. Communities leading for health this was the local authorities that work with the national transport charity Sustains are to build over 11,260 km which is 7000 miles of new cycle lanes and tracks. Health as a way of life this was in the NHS health trainers that will help individuals to make a healthy choice and stick to them this will be a new kind of personal health resources. A health promoting NHS all of the NHS staff will be trained to deliver key health messages effectively as part of their day to day work with the patients. And the last one is work and health this is that the NHS will become a model employer.
Public Health Agencies:
Health Protection Agency (HPA): This is an independent organisation that is dedicated to protecting individual’s health in the UK. It does this by providing impartial advice and authoritative information on health protection issues to the public, professionals and the government. It combines the public health and scientific expertise, research and the emergency planning within one organisation. It also works at international, national and regional and local levels and has links with many other organisations around the world. The HPA provides impartial expert advice on health protection and provides specialist health protection services, identifies and responds to health hazards and emergencies that have been caused by infectious disease, hazardous chemicals, poisons and radiation and anticipates are prepares for emerging or future threats, supports and advices other organisations with a health protection role and improves knowledge about the health protection through research and development, education and training.
National Institute for Health and Clinical Excellence (NICE): This is also an independent organisation that is responsible for providing national guidance on the promotion of good health and preventing the treatment of ill health. The Department of Health commissions NICE to develop the guidance to inform practice in: Clinical practice this is the appropriate treatment and the care of individuals with specific disease and conditions within the NHS. Public health this is the promotion of good health and the prevention of the ill health for those who are working in the NHS, local authorities and the wider public also voluntary sector. Health technologies this is the use of new and existing medicines, treatments and the procedures within the NHS.
Target setting:
National:
International:
Key Groups: Influencing Public Health:
Pressure Groups, e.g. Greenpeace and Friends of the Earth: Pressure group is a collection of people who hold similar beliefs based on the religion, ethnicity, political philosophy or a common goal. Based on these beliefs there are actions to promote the change and further their goals.
Greenpeace: this is a world-wide non-profit organisation that campaigns to stop the climate changes, protects the ancient forests, saving the oceans and stops the nuclear threats.
Friend of the Earth: this is an environmental pressure group that influences practices and policies. It campaigns to fight the climate changes, challenging the influence on the global trade system, exposing the poor businesses practice, reduces the impact on the environment of the movement of individuals and goods and protecting the wildlife habitats. However their health role is really specifically illustrated by their work on greener farming and campaigns for the increased recycling and reducing waste.
Internationals groups e.g. WHO and United Nations: this is the organisations operating level which includes a wide range of charities such as the Save the Children, Oxfam and Christian Aid also pressure groups like the Greenpeace and the statutory organisations that can be like the United Nations, World Health Organisation (WHO), UNICEF and the European Commission.
The World Health Organisation (WHO): the World Health Organisation began on the 7th of April 1948 this was followed by a proposal to establish a new autonomous International Health Organisation. The World Health Organisation constitution defines it as a directing and co coordinating authority in the International Health Work as it aim being the attainment by all individuals of the highest possible level of health. These are the responsibilities strengthening the health services, gives information about advice and assistance in the fields of health, international standard of food biological and pharmaceutical products and it improves the nutrition, housing, sanitation, work conditions, environmental hygiene and other aspects of the environment.
United Nations (UN): this is central to global efforts to solve problems that challenge humanity. Cooperating in this effort are more than 30 affiliated organisations that are known as the UN system. The UN and its family of the organisations work constantly to promote respect for the human rights, protecting the environment, fighting diseases and reduces poverty. The United Nations agencies defines the standards for safe and efficient air travel that helps to improve telecommunications and enhances consumer’s protections. The United Nation leads international campaigns against drugs trafficking and terrorism. All around the world the United Nations and its agencies assist refugees and sets up programmes to clear landmine, expands food production and leads to fight against AIDS.
References:
http://www.choleraandthethames.co.uk/cholera-in-london/cholera-in-soho/edwin-chadwick/
http://oyc.yale.edu/history/hist-234/lecture-11
Merit:
For this part of the assignment I will be comparing the 19th, 20th and 21st century in relation to the public health strategies used in the United Kingdom. I will also be comparing the similarities and differences of the living conditions in the towns and cities between the three centuries. By comparing the differences between the 19th, 20th and 21st centuries.
In the 19th century the living conditions caused a lot of deaths. This was because of the health that was very poor and people went through a lot of health issues such as overcrowded housings which was seemed to be normal in the past however it still does occur nowadays but it is very rare compared to the past it also caused an rapid spread of disease, pollution and poor environment as people were ignorant to the cause and the consequences of the pollution and the poor sewage system which had taken terrible smell that was awful for living however now a days we have an weekly collection of bins and we also have a complete sewage system.
Sanitation wasn’t regulated and cleanliness wasn’t a high priority whereas now a days individuals have standards of how to be clean and help to regulate the service of cleanliness.
Also the poor law system in the 19th century this strategy was set out to take care of the under privileged like the lower class individuals. In the 19th century there was also a part of the cholera outbreak which had claimed a lot of lives. The cholera outbreak that was killing individuals became an interest to Dr John Snow (1813 – 1858). He did a number of investigations and he eventually found out in his investigation that a particular water supply that was coming from the contaminated water was the cause of the cholera outbreak.
In the Beveridge’s report that was in the 20th century helped as it bought in the change to the educational standards in the areas that were more affected by poverty. In the report it also stated that all of the working people must pay weekly contribution’s which were used as benefits by the government to pay individuals who were sick, widowed, unemployed and retired. The benefits helped the under privileged to meet some of their basic needs which were impossible for them in the 19th century. Also Education in the past wasn’t very advanced and not many individual’s had the knowledge to read and write. This caused a lot of problems for individuals as they couldn’t understand for example what type of medications they was taking, why they had them and what problems it could cause this was because of the lack of education back then.
Another example is the life expectancy in these days for a man is 79, 80 years and a women’s life expectancy is 82,83 years old however about 100 hundred years ago the life expectancy for a man was 40 years and a women was 42 years old. This has changed over time as education and knowledge has increased overtime and also medication has developed over the years and individuals have started to be a lot more active and are eating healthier to back then.