July 1848
Public Health Act

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Enacted following a cholera epidemic, the Act sets up a General Board of Health in London. Acting as an advisory body, this tries to improve water supplies, sewage and general sanitation, as recommended by Chadwick's 1842 report. However, it is hamstrung by having no powers to compel action. All it can do is create local Boards of Health where 10% of ratepayers are in favour, or in areas where the death rate is more than 23 in every 1,000 people. These local Boards can then advise on water supplies, sewage, drainage and cemeteries, and they can appoint medical officers of health. But none of these bodies or individuals can force a measure through.

In some areas, the Boards manage to make a difference. In London, medical officer John Simons helps organise the installation of piped water and sewers, and the death rate falls. But in many places, ratepayers reject the Boards because they fear the cost. Where they exist, Boards make slow progress, as they have to win round the private companies and local authorities in charge of water, sewage and burials. After six years, Boards of Health exist for only 15% of the population.

In 1854, leading lights Edwin Chadwick, Lord Shaftesbury and Dr Southwood Smith are forced to resign from the General Board of Health, and the Board itself is abolished in 1858. Cholera, tuberculosis and smallpox will go on ravaging poor districts for the next 20 years.

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