Video: How and why did ideas about responsibility for public health change?

﻿Hello and welcome to another lesson about the history of medicine. This time we'll be looking at changes in the British government's attitude and approach in improving the health of the people. This lesson will link to some of the previous lessons in this unit, but this lesson will also make perfect sense on its own. My name is Mr. Prudden and I will talk you through step-by-step everything you need to know about this topic. For today's lesson, all you will need is a pen and paper or something to write on. And please take a moment to find a quiet space to work of no distractions. As always, it will be sensible to keep all your notes together, so you have a knowledge pack for medicine through time. When you have found a quiet space and you're ready to start, let's begin. In this inquiry and in the last few lessons, you've been looking at how quickly ideas about prevention and treatment changed over time. Before we continue, can you remember which time period the following events took place in? Even better if you can give me a date. So we have John Snow's cholera findings rejected by the government. The Black Death. The Great Plague. Edward Jenner discovered a vaccine against smallpox. New London sewers were completed. Compulsory vaccinations against smallpox. So, press pause and then resume when you're ready to continue. Well done, great effort. So let's run through those answers. So the Black Death in the Middle Ages, 1348. The Great Plague in the Renaissance, 1665. Edward Jenner discovered a vaccine against smallpox during the Industrial Revolution in 1796. And John Snow informed the British government that cholera was transmitted by dirty drinking water in 1855, again the Industrial Revolution. Another event in the Industrial Revolution, so the British government enforced compulsory vaccinations against smallpox in 1872 and the government's investment into new sewers was completed by 1875. In the Middle Ages, governments prioritised fighting wars, defending their people during war time and punishing law breakers who threatened the peace in the country. This meant the job of keeping the people in towns healthy was assigned to local councils. But with most money going on war and defence, there was precious little money left for this. In the Renaissance times, governments still did not spend money on trying to improve people's health or finding out more about medicine, apart from when there was a major outbreak of plague in 1665. A few lessons back, we discussed how the government in 1665 were proactive in preventing the plague spreading. For example, they banned public meetings, fairs and funerals, and appointed searchers and wardens to measure the spread of the disease. By 1800, the government still had little interest in spending money on improving people's health and conditions in towns and cities. They had a laissez-faire attitude. Laissez-faire is a French term and it means, leave be. We use it to describe governments who don't get involved in day-to-day lives of their population. Indeed, the government in 1800 believed it wasn't their responsibility to interfere in the way people lived. If people were unhealthy, that was their problem. Now listen to these developments. So in 1840, the government makes smallpox inoculation a crime and agreed to provide children with smallpox vaccination at the taxpayer's expense. In 1848, the government passed the First Public Health Act. In 1871, the government appointed public vaccinators. In 1872, the government began to enforce compulsory vaccination. In 1875, they passed the Second Public Health Act. And in 1875, the government investment in to new London sewer systems, was completed. So in the last quarter of the 19th century, as you can see in this timeline, the government was actively making laws to improve people's health, forcing changes on people. Why was there a U-turn in government approach? This is what we will be seeking to answer this lesson. So what links the following events? During the Great Plague of 1665, public meetings, fairs and funerals were banned. In 1872, the British government began to enforce the compulsory smallpox vaccination. Joseph Bazalgette designed a new sewer system in London. In 1871, public vaccinators vaccinated people against smallpox. So think carefully, press pause, and once you've got an answer and you're ready to continue, press play. Well done, that's right. They are all examples of actions taken by the government to improve the health of the people. The new sewer system. if you remember, was completed in 1875. So you can see that the government was much more active in helping to improve the health of the people by that last quarter of the 19th century. In 1842, Edwin Chadwick reported to the government, the effects of malnourishment and poor sanitary conditions on people. For example, he concluded that in rural areas, so in the countryside, the average age of death was 38, yet in cities like Liverpool, the average age of death for workers, was only 15. Six years later, the government sort of took action by introducing the first Public Health Act, which encouraged cities to set up boards of health and provide clean water supplies. However, it encouraged and recommended local councils to take action, but it was not compulsory. So whilst the step in the right direction, because it was optional, it had very little impact. Remember, the first Public Health Act came before Louis Pasteur's publication of germ theory in 1861. There was no scientific evidence in 1848 to help persuade politicians to enforce public health changes. Similarly, John Snow's report to the government in 1855, that cholera was transmitted by dirty drinking water, was rejected by the government because it was before Pasteur published his germ theory. Politicians simply could not begin to understand why the water was causing cholera. His recommendation that new sewers needed building would also prove costly, which the government was not prepared to kick up the expense for, with no scientific proof to back up the need for them. Remember, when the government did invest in Joseph Bazalgette to modernise the London sewer system, this was not because of Snow. It was really down to self-interest. Because of the very hot and dry summer in 1858, which had caused The Great Stink, the Thames was low and the stench from the exposed sewage on the riverbanks persuaded the government that something needed to be done. They simply couldn't do the job in London, in the Houses of Parliament with that awful smell. This project use engineering methods, not available a hundred years earlier, such as machinery powered by steam engines. In total 83 miles of main sewers, 1,100 miles of connecting sewers and pumping stations to drive the flow of sewage along the pipes, were built. And the modernised sewer system was completed by 1875. From the 1860s, the government began to take more action to improve the living conditions for people in cities, such as Birmingham, where slums were demolished. The government passed the second Public Health Act in 1875. This provided city authorities with compulsory rules they had to adhere to. All city authorities had to, provide clean water, to stop diseases that was spreading in dirty water. Dispose of sewage, to prevent drinking water and washing water from becoming polluted. Build public toilets to avoid pollution. Employ a public office of health, to monitor outbreaks of disease. Ensure new houses are of better quality to stop damp and overcrowding. Provide public parks for exercise. Create street lighting to prevent accidents. And to check the quality of food in shops, to make sure that it didn't contain anything that could cause harm to people. For example, some bakers mixed chalk into flour to make bread whiter. The cartoon on this slide points to the problem with food before this act. The fact that there was no further cholera epidemics shows that the second Public Health Act had its intended impact. Further evidence of success, in 1868, there were 716 deaths from typhus in London, but by 1885 just 28 and by 1900 there were none. Okay, so I've given you five answers. So answer A, the first Public Health Act. B, The Great Stink. C, 83 miles. D, it was compulsory. E, in the year 1861. So if these are the answers, what might the questions be? Press pause and resume when you're ready to continue. Well done. So these are just examples, you may have come up with different questions. So the answer, the first Public Health Act. So the question could be, which Public Health Act was optional and therefore had little impact on the health of the people? The second answer is The Great Stink. So the question could be, what did the smells from the exposed sewage on the banks of the River Thames in 1858 become known as? The third answer, 83 miles. So the question could be, how many miles of modern sewers were built in London by 1875? For D, the answer was, it was compulsory. But what was compulsory? So the question could be, why did the second Public Health Act have a greater impact on the health of the people then the first? And the final answer, in the year 1861. Well, the question could be, in what year did Louis Pasteur publish his germ theory? So why was the government getting more involved? Certainly, The Great Stink of 1858 gave the government some impetus to improve the sewer systems in London. But this on its own is not enough to give a sufficient explanation for why the government took more direct action in the second quarter of the century. In 1861, Louis Pasteur proved that there was a link, a scientific link between dirt and disease. John Snow had been correct in his arguments, but he did not know that it was bacteria in the water that spread cholera. Because of Pasteur, the fear of the illness was caused by bad air, miasma, finally faded away. And in the 1870s and 1880s, Robert Koch identified individual bacteria, for example, the cholera bacteria in 1883. Faced with scientific proof, the government were more willing to fund public health reforms. In 1867, working men in towns were given the right to vote for the first time. This meant the number of votes doubled. The numbers increased again in 1884, when many working men in the country areas also got to vote. If politicians wanted to win elections, they now have to promise laws to win the votes of working man, not just the wealthy. So the 1870s and 1880s saw many new laws passed, designed to improve the lives of ordinary people. So by 1900, there had been a major shift in the role of government with regards to public health. The laissez-faire attitude had been replaced by an acceptance, that it was the role of the government to ensure people lived healthy lines. This government involvement in the health of the people would continue into the 20th century and beyond. So let's read through the comprehension questions carefully. Question one. Why did the first Public Health Act have only a limited impact? Question two. Why did the government invest in Joseph Bazalgette to modernise the London sewer system? Question three. Can you explain three reasons why the second Public Health Act improve the health of the people? Question four. Why did the events of 1861 and 1867 lead to the second Public Health Act? And question five is your challenge question. How far do you agree that Louis Pasteur's germ theory was the most important reason why the British government's laissez-faire attitude came to an end? Remember, laissez-faire means leave be, we use it to describe governments who don't get involved in day-to-day lives of their population. And in 1800, the British government didn't think it was their responsibility to interfere in the health of the people. So was it Pasteur's germ theory that made the British government reject their laissez-faire approach? Or was it something else? You may wish to use the sentence starters I have provided for you. So now pause the video, read the slides on the resource worksheet very carefully and answer the comprehension questions. And when you're finished, press play to continue. Very well done for working hard answering those comprehension questions. Let's review your answers. So question one. Why did the first Public Health Act have only a limited impact? Well, the first Public Health Act encouraged and recommended local councils to set up boards of health and provide clean water supplies. However, it was optional. This meant most local councils did not implement the recommendations. Question two. Why did the government invest in Joseph Bazalgette to modernise the London sewer system? The government invested in Bazalgette to modernise the London sewer system because of the very hot and dry summer in 1858, which had caused The Great Stink. The Thames was low and the stench from the exposed sewage on the riverbanks persuaded the government that something needed to be done. Question three. Can you explain three reasons why the second Public Health Act improved the health of the people? So here are some examples, you may have come up with different examples and that's fine. So all city authorities had to, provide clean water to stop diseases that was spread in dirty water and dispose of sewage to prevent drinking water and washing water from becoming polluted. They had to build public toilets to avoid pollution. City authorities had to employ a public officer of health to monitor outbreaks of disease. They had to ensure new houses are of better quality to stop damp and overcrowding. They had to provide public parks for exercise and check the quality of food in shops to make sure that it didn't contain anything that could cause harm to people. Remember our example, some bakers mixed chalk into flour to make bread whiter. Question four. Why did the events of 1861 and 1867 lead to the second Public Health Act? So in 1861, Pasteur proved that there was a scientific link between dirt and disease. John Snow had been correct in his arguments, but he did not know that it was bacteria in the water that spread cholera. In the 1870s and 1880s, Robert Koch identified individual bacteria, for example, the cholera bacteria in 1883. So faced with scientific proof, the government were more willing to fund public health reforms like the second Public Health Act. And in 1867, working men in towns were given the right to vote for the first time. Now this meant, the number of votes doubled and if politicians wanted to win elections, which they did, they now had to promise laws to win the votes of working men, not just the wealthy. So in the 1870s and 1880s, we see many new laws passed, like the second Public Reform Act, designed to improve the lives of ordinary people, in order to win support for those elections. And question five was your challenge question. How far do you agree that Pasteur's germ theory was the most important reason why the British government's laissez-faire attitude came to an end? So here's some evidence to agree. So before Pasteur, the government had rejected Snow's ultimately correct arguments in the 1850s, because he did not know that it was bacteria in the water that spread cholera. Pasteur's germ theory proved that there was a scientific link between dirt and disease and in the 1870s and 1880s, Robert Koch identified those individual bacteria like cholera in 1883. Faced with scientific proof, the government were forced to abandon their laissez-faire stance. They can no longer justify doing nothing, science was telling them that there was a link between dirt and disease, hence why they implement lots of public health reform. And evidence to disagree. As always, don't worry if you've come up with with something different, but these are the main two counter arguments. So The Great Stink of 1858 meant the government actively invested in improving sewer systems in London, which went against their laissez-faire stance. And in 1867, working men in towns were given the right to vote for the first time. So if politicians wanted to win elections, they now had to promise laws to win the votes of the working man, like the second Public Reform Act in 1875 was designed to win support from the working classes. So the need to please working man, so as to win elections, forced the government to abandon their policy of laissez-faire. A really big well done for completing today's lesson. Next lesson, you will look at how hospitals and hospital treatment changed over time. And in particular, key developments in the 19th century. It would be a good idea now to see if you can describe three actions the government took in the last quarter of the 19th century to improve public health. And don't forget to see how much you've learned in this lesson by taking the exit quiz now. Thank you for working hard today, take care and enjoy the rest of your learning for today.

Worksheet: How and why did ideas about responsibility for public health change?

Exit Quiz: How and why did ideas about responsibility for public health change?

Completed: How and why did ideas about responsibility for public health change?

In this lesson you will learn how and why government action in improving the health of the people dramatically increased in the last quarter of the 19th century. You will understand why 'the Great Stink', germ theory and new voting laws changed government attitudes.

History

Y10 History

Key Stage 4

Year 10

How and why did ideas about responsibility for public health change?

Medicine through time, c.1250-present day

UNIT

How much medical progress did ancient Greece and Rome make?

What did people think about where disease came from in medieval Britain?

How did people in medieval times try to prevent and cure diseases?

Who did people go to for medical help in medieval times?

What can the Black Death tell us about medieval medicine?

How much medical progress was made during medieval Britain?

Why was there greater medical progress between 1500-1700?

Why did ideas about causes of disease change between 1500-1700?

How did individuals change medical understanding between 1500-1700?

How did ideas about the cause of disease change between 1700-1900?

Why did ideas about the cause of disease change between 1700-1900?

How did ideas about causes of disease change after 1900?

How quickly did ideas about causes of disease change and why did ideas change over time?

Did ideas about prevention and treatment change between 1500-1700?

How did approaches differ in dealing with the Great Plague compared to the Black Death?

When did vaccination really start to make a difference to health in Britain?

How far did John Snow change ideas about the prevention of disease?

How did hospitals change over time and improve prevention and treatment of illness and disease?

Why were there improvements in surgery?

Did the NHS transform medicine in Britain?

How far did treatment advance in the 20th century?

How important was the role of chance in the discovery and development of penicillin?

How has the use of science and technology changed ideas around the treatment and prevention of lung cancer?

How quickly did ideas about prevention and treatment of disease change and why did ideas change over time?

How were trenches designed and why did battles on the Western Front lead to medical advancement?

What medical conditions were there on the Western Front?

How far did war on the Western Front give rise to new techniques in medical treatment?

How were wounded soldiers helped on the Western Front?

How far did WW1 accelerate medicine and treatment in the 20th century?

History

How and why did ideas about responsibility for public health change?

Video

Worksheet

Final Quiz

Lesson Complete