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The Evolution Of Public Health In England

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This essay will critically evaluate changes of Public Health England and how it has historically shaped and developed over the centuries. It will highlight key political drivers, policies and practice in public health in England and internationally. This will be achieved by discussing historical events in public health, improvement of framework, the setting up of the National Health Service and establishment of Public Health England and organisations working closely with.

Historically Public Health was not recognised. Industrial revolution at the beginning of 18th century affected people as there were poor living condition, massive poverty, not access to a clean water, bad sanitation and lack of medical services.

In 1831 severe cholera outbreak occurred in United Kingdom and in 1832 the medical community started an investigation on protentional causes of cholera. There were many theories but very little understanding of disease. Most people thought it was spread by miasma a bad smell. In 1842 Edwin Chadwick published report “The Sanitary conditions of the Labouring Population of Great Britain”, which explored the link between poor living conditions and diseases. The Government did not payed an attention upon this issue, they followed policy laissez faire, but they were forced to act in 1848 when epidemy of cholera returned.

First Public Health Act 1848 was published. It was a first important step in history of public health, to improve public health as that time they were loads of issues around diseases, which was associated with a poor living conditions, vaccinations and this is where role of the public health began with instruction of public health act and had an influence for other countries such as United States.

It was not compulsory, and it was funded by a council and not by a government. General Board of Health has been entrenched by Public Health Act with limited powers and not enough funds (Baggot, 2011). In 1854 John Snow published his findings about the spread of cholera, however it took a time to his theories to be accepted by nation as people did not believed scientist. Snows endorsed findings were a big step to sanitation improvement.

In 1875 came into a force the second Public Health Act following recommendations of the First Act which set clearer framework for Public Health. New framework was set for next 50 years (Baggot, 2000).

New liberal government was elected in 1906 and took an action to improve public health. Liberal welfare reforms were introduced Some of the reforms were not compulsory and councils ignored them and many children in need were affected. The 1906 Education (provisions of meals) Act, (Stewart, 1999) was introduced to provide a free meal for children. In 1907 under Education Act, medical school inspections took a place and they were compulsory. In 1911 National insurance scheme was introduced and old age pensions.

Government structure was reinforced by establishment of The Local Government Act in 1929 which put an end to Poor Law in England and Wales. It meant transferring power to county authorities and quality improvement in hospitals. It was a big progress of public health.

In 1941 commission was set up by government to look at what needed to be done after the war. Sir William Beveridge was in charge and in 1942 and he created Beveridge report which was built on strong foundation with an aim for healthier Britain. His recommendation for setting up welfare state came into consideration, which meant that state should take responsibilities for a welfare of the nation.

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In 1945 Clement Atllee leader in power of Labour government promised to tackle beverages report.

In July 1948 the National Health Service was created and it was biggest Health and Social reform in history of Britain. Doctors, nurses, health professionals and hospitals came together for very first time which saw death rates go down and people started to live longer (NHS Video). The main individual behind of creation of National Health Service was Aneurin Bevan who created welfare state for everybody to receive treatment at the point of need free of charge.

Margaret Thatcher, the leader of Conservative government, in 1979 promised to do more on improvement of public health and underlined also an importance of prevention. Following year Black report was published and stated that in health there are inequalities between rich and poor people and an aim was to close those gaps. Importance of promoting health has been formed in the Ottawa Charter in 1986 at the First International Conference on Health Promotion (Ewless L., 2005).

Health improvement was recorded in governments strategy of health for England in 2004 which concentrate more on individuals and choice how to live was promoted (DoH, 2004).

Public Health became in 2013 Public Health England under Department of Health, which outline the quality of life and increase life expectancy and pays an attention on inequalities in health to understand and reduce them. It brought more clearer structures, more clearer functions in terms of protecting the public and trying to improve publics behaviours around some issues about smoking, alcohol use, drug use.

Focus of Public health gone from the responsibility of the state to the responsibility of the individual. It is everyone’s responsibility to improve our lifestyles.

World Health Organisation (WHO) was established in 1948 with an aim to fight against diseases and epidemics across the world and is working in partnership with Public Health England to improve and tackle public health issues. It set health standards and guidelines and deal with these issues internationally (WHO, 2007). As an example, loads of investments are put in to research and technology for immunisation, vaccines and their development where in 18th century as mentioned above people did not believed the scientist and they been fearful as they believed god. Epidemics of smallpox was not under the control until Edward Jenner created a vaccination against smallpox in 1796 and in 1967 worldwide campaign has been started by WHO to eradicate smallpox. In comparison 18th century throughout now there is more cures for different diseases and people are more educated about what is causing them, and it help for prevention across the countries and worldwide.

Changes of public health were beneficial in the United Kingdom and across the world and there is till more to be done as with a new population and with changing circumstances we are facing to a new issues and problems. They are many areas in public health that need to be focus on such as population control, terrorism, drug misuse and natural disasters. According to David Gauke, secretary of state for work and pension, fourth industrial revolution is starting with giant challenges and opportunities (Department for Work and Pensions and Rt Hon David Gauke MP (2017).

Great importance in public health play a role some of the famous people such as Jamie Oliver who introduced healthy food and nutrition of the food at schools and introduced healthy policy for public for a healthier lifestyle (Scriven & Garman, 2007).

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The Evolution Of Public Health In England. (2021, September 13). Edubirdie. Retrieved February 26, 2024, from
“The Evolution Of Public Health In England.” Edubirdie, 13 Sept. 2021,
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