Intended for healthcare professionals

Education And Debate Personal paper

The 1848 Public Health Act and its relevance to improving public health in England now

BMJ 1998; 317 doi: (Published 29 August 1998) Cite this as: BMJ 1998;317:596
  1. Kenneth Calman, chief medical officer
  1. Department of Health, Richmond House, London SW1A 2NS

    Editorials by Alderslade, Palmer Recent advances p 584 Education and debate pp 587, 592

    I keep copies of all major acts of parliament relevant to health and health care. I have consulted them from time to time over the past seven years. However, it is the 1848 public health act (An Act for Promoting Public Health) that I have looked at most regularly. Why does this act fascinate me, and why did I wish to see further reflection on its background and consequences? The answers lie in an understanding of the context of the act and its consequences. This is not because of the act's specific contents—though the regulations on slaughterhouses and the selling of meat are fascinating—but because of the general issues the act raises:

    • The principles of improving the public health

    • The role of the state in improving the health of the people

    • The organisation of public health at all levels in England and Wales

    • The consequences of the act and the manner in which it raised the profile of public health

    • The links to current issues in health and health cre.

    Summary points

    The 1848 act identified all the major public health issues of the time and established a structure for dealing with them

    Public health became the responsibility of local people

    Though health has improved immeasurably since 1848 some problems remain; the act's approach remains relevant today

    The purpose of the act was to promote the public's health and to ensure “more effective provision … for improving sanitary conditions of towns and populace places in England and Wales.” Such clarity of purpose is impressive. The background to the act was a remarkable piece of work on mortality and morbidity rates across the country. The work established clear inequalities in health and recognised that some fundamental issues, such …

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