Public Health Reform in the 19th century (Classroom Activity)

The government decided to order a full-scale enquiry into the health of British people. The person put in charge of this enquiry was Edwin Chadwick. His report, The Sanitary Condition of the Labouring Population, was published in 1842. In 1847 the British government proposed a Public Health Bill that was based on some of Chadwick's recommendations. There were still a large number of MPs who were strong supporters of what was known as laissez-faire. This was a belief that government should not interfere in the free market. They argued that it was up to individuals to decide on what goods or services they wanted to buy. These included spending on such things as sewage removal and water supplies.

Supporters of Chadwick argued that many people were not well-informed enough to make good decisions on these matters. Other MPs pointed out that many people could not afford the cost of these services and therefore needed the help of the government. The Health of Towns Association, an organisation formed by doctors, began a propaganda campaign in favour of reform and encouraged people to sign a petition in favour of the Public Health Bill. In June 1847, the association sent Parliament a petition that contained over 32,000 signatures. However, this was not enough to persuade Parliament, and in July the bill was defeated.

In an attempt to persuade the supporters of laissez-faire to agree to a Public Health Act, the government made several changes to the bill introduced in 1847. For example, local boards of health could only be established when more than one-tenth of the ratepayers agreed to it or if the death-rate was higher than 23 per 1000. Chadwick was disappointed by the changes that had taken place, but he agreed to become one of the three members of the central Board of Health when the act was passed in the summer of 1848. However, the act was passed too late to stop the outbreak of cholera that arrived in Britain that September. In the next few months, cholera killed 80,000 people. Once again, it was mainly the people living in the industrial slums who caught the disease.

Primary Sources

William Pyne, waterman (1806)
(Source 1) William Pyne, waterman (1806)


(Source 2) George Hudson, speech in the House of Commons (3rd July 1847)

I admit that there was a very general feeling in Yorkshire in favour of the adoption of some sanitary regulations, and that petitions praying the House to consider and sanction such measures had been presented from corporations and from public meetings.... I think that the evils resulting from defective sanitary regulations had been very much exaggerated, and I hope the House would pause before they gave their assent to this measure... The country is sick of centralisation of commissions of inquiries. The people want to be left to manage their own affairs; they do not want Parliament to be so paternal as it wishes to be - interfering in everybody's business.

(Source 3) Robert Rawlinson, a Board of Health Inspector, letter to Edwin Chadwick (30th September 1852)

On my arrival in Hexham, I found the town in a state of ferment as to the inquiry, the bellman was perambulating the streets summonsing the ratepayers to a meeting to oppose the inquiry.... I then requested any persons having evidence to offer either for or against to come forward and tender it. the opponents entered most resolutely into the arena, declaring that Hexham was well supplied with water; and was, in all other respects, a perfect town. I inquired for the return of the mortality, and found that, for the last seven years, it was actually some 29.5 in the thousand, but with "cooked" returns it was 24.5 in the thousand. I then called the Medical Officers and the Relieving Officers and soon got amongst causes of fever, small-pox, and excessive money relief. I then traced disease to crowded room tenements, undrained streets, lanes, courts and crowded yards, foul middens, privies, and cesspools. The water I found was deficient in quantity and most objectionable in quality, dead dogs having to be lifted out of the reservoir. And though the opposition fought stoutly they were obliged publicly to acknowledge that improvement was needed - they, however, dreaded the General Board, and the Expense. I then explained the constitution of the Board and stated that their powers would be used to instruct, protect, and to check extravagant expenditure. By this time the eagerness of the opponents had somewhat subsided, the body of the meeting had come partially round, and so I entered into an examination of the promoters who came willingly forward. At the termination of the inquiry several of the opponents came forward and stated that I had removed their objections and they wished the Act could be applied immediately.

George Scharf, Laying a Water-Main in Tottenham Court Road (1834)
(Source 4) George Scharf, Laying a Water-Main in Tottenham Court Road (1834)


(Source 5) On 3 July, 1849, The Times published a letter from a group of people living in Carrier Street, London.

We live in muck and filth. We ain't got no privies, no dustbins, no drains, no water supplies, and no sewers in the whole place... We are living like pigs, and it ain't fair... We hope you will let us have our complaints put into your influential paper, and make the landlords... make our houses decent for Christians to live in.

(Source 6) Thomas Hawksley, interviewed by a Parliamentary Committee (15th February, 1844)

Q: What has been the effect produced on their habits by the introduction of water into the houses of the labouring classes?

A: At Nottingham the increase of personal cleanliness was at first very marked indeed; it was obvious in the streets. The medical men reported that the increase of cleanliness was very great in the houses, and that there was less disease.

Q: When, on the return home of the labourers' family, old or young, tired perhaps with the day's labour, the water has to be fetched from a distance out of doors in cold or in wet, in frost or in snow, is it not well known to those acquainted with the labourers' habit that the use of clean water, and the advantages of washing and cleanliness, will be foregone to avoid the annoyance of having to fetch the water?

A: Yes, that is a general and notorious fact. When the distance to be traversed is comparatively trifling, it still operates against the free use of water.

Q: Before the water was laid on in the houses of Nottingham, were the labouring classes accustomed to purchase water?

A: Before the supply was laid on in the houses water was sold chiefly to the labouring-classes by carriers at the rate of one farthing a bucket; and if the water had to be carried any distance up a court a halfpenny a bucket was, in some instances, charged. In general it was sold at about three gallons for a farthing. But the Company now delivers to all the town 76,000 gallons for £1; in other words, carries into every house 79 gallons for a farthing, and delivers water night and day, at every instant of time that it is wanted, at a charge 26 times less than the old delivery by hand.


Nightmen removing sewage in London (1849)
(Source 7) Punch Magazine (3rd July, 1858)

(Source 8) C. P. Hill, British History (1951)

The doctrine of laissez-faire and the absence of government control was a disaster for the factory towns and the people who lived in them.

(Source 9) Irving L. Gordon, World History (1983)

With the coming of the Industrial Revolution, the new production methods required large amounts of capital. Capital was necessary to build factories, purchase machines, secure raw materials, and pay workers... This economic system, based on private capital is known as capitalism. In the late 18th century... capitalists wanted to manufacture and sell their goods free from government interference. They favoured laissez-faire (leave business alone)... but it has been sharply modified or rejected by industrial nations today. (9)

Gustave Dore, London (1872)
(Source 10) Punch Magazine (1848)


Questions for Students

Question 1: Describe what is taking place in sources 1 and 4. How does source 6 help to explain why water pipes were eventually laid in all British towns?

Question 2: How does source 3 help to explain why historians do not always agree about how bad public health was in the 19th century?

Question 3: Why did people living in Carrier Street write to The Times in July, 1849?

Question 4: Study source 9. Describe one aspect of the British economic system today that is similar to the late 18th century. Describe one that is different.

Question 5: (a) What is the meaning of the term laissez-faire? (b) Is George Hudson (source 2) a supporter or opponent of laissez-faire? (c) Use the information in sources 8 and 10 to explain why most MPs gradually changed their mind about the doctrine of laissez-faire.

Question 6: What were the short-term and long-term reasons for Parliament passing the 1848 Public Health Bill?

Answer Commentary

A commentary on these questions can be found here.