www.chronology.org.uk

A Chronology of State Medicine, Public Health, Welfare and Related Services in Britain. 

1066 - 1999.

Compiled By

Emeritus Professor of Social Medicine, University of Kent at Canterbury

formerly

Reader in Public Health, London University

‘Those who cannot remember the past are condemned to fulfill it."   G. Santayana 1905

This chronology records key parliamentary acts, reports of royal commissions and inquiries and other events that have been the bases of the development of intervention by central and local government in the control of factors harmful to health, in the provision of preventive medical, public health and related services, and in the provision of general practice and hospital services in England, Wales and Scotland (mainly from 1707). The intention is to provide a "map" of events for those wishing to explore particular aspects of the subjects covered, and to enable each event to be seen in the context of contemporary occurrences. To pursue any one subject in depth it will be necessary to refer to the original items themselves, as their contents are only briefly, and sometimes partially, indicated in the text. The chronology is an aid to the study of history, it is not a history in itself. Outstanding histories of public health and related subjects are listed in the bibliography.

The origin of this chronology was a collection of dates of various events, which I recorded throughout my professional career. In 1970 some of my material was published in tabular form in The Medical Officer (1970, vol. 123, pp. 229-232). This aroused widespread interest and subsequently I received, from time to time, requests for guidance about dates and past events. During the last two years I have checked and substantially added to the original material, so that there are now about 3000 entries compared to about 1000 in 1970. Much of the new material refers to activities during the last 30 years.

The choice of material to be included was at times difficult, given the breadth of the interlocking interests to be covered. Inevitably there is a bias from my own special interests. As for completeness, many sources have been studied and searched. These included "Statutes at Large", bound volumes of the public general acts, indexes of royal commissions and inquiries and the reports of some of them, the "Concise Dictionary of National Biography", "Who Was Who", "Munk’s Roll", "Whitaker’s Almanack" from its first edition in 1868, the "British Medical Journal", "The Lancet" and the books listed in the bibliography among others. Even so there will be items and names that readers will look for in vain. I apologise, and will be interested to hear details of these omissions.

The chronology starts in 1066 following the radical reform of the structure of central and local government at that time; it ends in 1999 with the recreation of the Scottish parliament, the setting up of the Welsh Assembly and the beginning of a comprehensive approach by central government to mailers affecting the health of the public. 

The first intervention by government in matters of public health was concerned with the repair of sewers and the removal of nuisances (1225)*. From then on governments increasingly legislated on public health and related matters. Sometimes governments had to respond to new situations and discoveries e.g.. industrialisation (1819) and radiation (1948); sometimes they tried new solutions to long-standing problems e.g. poverty (1601 and 1946) and support of children of wayward fathers (1576,1733 and 1991); sometimes legislation codified what had become common practice in many places e.g. maternity and child welfare services (1918); sometimes it stopped abuses e.g. selling poor quality products (1266), child labour (1819) and adulteration of food (1860); sometimes legislation set a pattern for future services e.g.. national insurance (1911) and the national health service (1946).

Some curious events and decisions are recorded. For example, in an act of 1542 a poor opinion of surgeons of that time is spelled out in the following words "for the most Part of the Persons of the said Craft of Surgeons have small Cunning, yet they will take great Sums of Money, and do little therefore, and by reason thereof they do oftentimes impair and hurt their Patients, rather than do them Good". Dr. James (sic) Barry was the first woman to qualify in medicine, be registered and serve in the British Army (1865). In 1862 the Senate on London University decided by a majority of one that the powers to confer degrees on "all classes and denominations ... without any distinction whatsoever" did not extend to females!

There are also many wise and far-seeing statements quoted in the chronology. Daniel Defoe proposed in 1697 that the insurance principle should be applied to the social problems of the poor, including disability pensions and medical and institutional care. Samuel Farr in 1788 called for local action to prevent or avert "everything which may tend to injure public health"; to ensure that the diseases of the sick poor were "as speedily as possible removed by the provision of qualified physicians" and the establishment of public hospitals; and to prevent and control infectious diseases. In 1870 The Lancet called for the amalgamation of medical schools in London, as it stated "all scientific men are convinced of the absurdity and practical impossibility of carrying on scientific teaching in eleven separate institutions in London". In 1932 Sir Arthur Newsholme observed about public services that "average humanity has not yet learned to use community privileges with due regard to communal economy in the absence of a personal motive for carefulness"; and, "the axiom that the object of a community service is to do away with group competition and bring in its place co-operation and teamwork is especially applicable to all public health and medical work; and the spirit of this axiom is infringed by the existence of a separate, sometimes competing, occasionally conflicting, services under local and central control". This echoed the recommendation of the Royal Sanitary Commission in 1871 that "all powers requisite for the health of towns and country should in every place be possessed by one local authority".

Michael Warren.

 2 Bridge Down,  Bridge, Canterbury, Kent CT4 5AZ

24 July 1999.

* The dates given in brackets refer to the date of the relevant entry in the chronology

Explanatory Notes

1.         For each year the entries, where applicable, are usually listed in the following order census and population figures; acts of parliament; White Papers; Green Papers; reports of royal commissions; reports of government inquiries, enquiries and working parties; other reports; creation of colleges, societies and associations; foundation of hospitals; events in preventive medicine and outstanding medical and scientific advances; publications; world health matters; foundation of universities; and general matters. This order is not always followed as sometimes it seemed appropriate to link entries referring to related matters.

2.         The dates given of acts, reports, foundations, etc. are the dates that the act was passed, report published or a charity or college was founded and not the dates on which the legislation was implemented or an institution became functional.

3.        Only the main points of acts and reports are summarised. Where the title of an act or report is self-explanatory no summary is given.

4.         Spelling in titles and quotations follows the original.

5.         Acts and reports are usually indexed under their subject matter and not under their titles which are given in the body of the chronology.

6.         The dates given in the index are to the years in which the subject is mentioned in the chronology. This may not always be the year in which the event occurred, for example changes of names of societies may be recorded in the entry of the foundation of the original society and the dates of births and deaths are given with the first entry of the name of the person.

7.         For some subjects there may be more than one relevant entry in the year indexed

8.         Colleges, societies and associations are usually indexed under the profession or concern of the particular body.

I am indebted to many people for their encouragement, advice and help in the compilation of this book. Many librarians, secretaries of colleges, institutions and societies and others answered queries about entries in the chronology. Andrew Boddy, Tim Carter, Iain Chalmers, Robin Dowie, James Dunlop, Felicity Edwards OBE, George Forwell OBE, Peter Gardner, Sir George Godber GCB, Wilfrid Harding CBE, Walter Holland CBE, Iain Macdonald CB, John Pemberton, Jean Richards, Geoffrey Rivett and Brian Williams commented and advised on a draft of the book; Caroline Wren prepared the draft for publication; and Joan Warren checked the typescripts and encouraged me over many years to complete the task. To all of these people I am very grateful and record my sincere thanks to them.

A short bibliography.

Abel-Smith, B., A History of the Nursing Profession. London, Heinemann, 1960.

Abel-Smith, B., The Hospitals. London, Heinemann, 1964.

Allan, P. and Jolley, M., Nursing, Midwifery and Health Visiting since 1900. London, Faber and Faber, 1982.

Briggs, A., A Social History of England. Harmondsworth, Penguin Books, 1987.

Brockington, C. Fraser, Public Health in the Nineteenth Century. Edinburgh and London, E.&S. Livingstone, 1965.

Brockington, C. Fraser, A Short History of Public Health. London, J.&A. Churchill, 1966.

Bruce, M., The Coming of the Welfare State. London, B. T. Batsford, 1968.

Byrne, T., Local Government in Britain. Harmondsworth, Penguin Books, 1994.

Chariton, J. and Murphy, M. (editors), The Health of Adult Britain 1841 - 1994. Volumes 1 and 2. London, The Stationary Office, 1997.

Edwards, B., The NHS Managers Tale 1946 - 1992. London, Nuffield Provincial Hospitals Trust, 1993.

Fee, Elizabeth and Acheson, R.M., A History of Education in Public Health. Oxford, Oxford University Press, 1991.

Fraser, W.M., A History of English Public Health 1834-1939. London, Bailliere, Tindall and Cox, 1950.

Harris, B. The Health of the Schoolchild. The History of the School Medical Service in England and Wales. Buckingham, Open University Press, 1995.

Hodgkinson, Ruth G., Origins of the National Health Service. London, Wellcome Historical Medical Library, 1967.

Loudon, I., Medical Care and the General Practitioner 1750 - 1850. Oxford, Clarendon Press, 1986.

Loudon, I., Horder, J. and Webster, C. (editors), General Practice under the National Health Service 1948 - 1997. London, Clarendon Press, 1998.

McLachlan, G., (editor) Improving the Common Weal. Aspects of Scottish Health Services 1900 - 1984. Edinburgh, Edinburgh University Press, 1987.

Mitchell, B.R., British Historical Statistics. Cambridge, Cambridge University Press, 1988.

Morgan, K. 0., The People’s Peace. British History 1945 - 1989. Oxford, Oxford University Press, 1990.

Morton, LT., A Medical Bibliography. London, Andre Deutsch, 1983.

Newman, Sir George, The Rise of Preventive Medicine. London, Oxford University Press, 1932.

Nissel, Muriel, People Count. A History of the GRO. London, HMSO, 1987.

Rivett, G.C, From Cradle to Grave. Fifty Years of the NHS. London, King’s Fund, 1998.

Rivett, G.C, The Development of the London Hospital System 1823 - 1982. London, King Edward’s Hospital Fund, 1986.

Simon, Sir John, English Sanitary Institutions. London, John Murray, 1897.

Stevens, Rosemary, Medical Practice in Modem England. Nes Haven, Yale University Press, 1966.

Tlimmins, N., The Five Giants. A Biography of the Welfare State. London, Fontana Press, 1995.

Titmuss, R.M., Problems of Social Policy. History of the Second World War. London, HMSO,

1950.

Trevelyan, 0. M., English Social History. A Survey of Six Centuries. London, Longmans, Green, 1946.

Walton, J., Beeson, P.B. and Scott, R. Bodley, Oxford Companion to Medicine. Oxford, Oxford University Press, 1986.

Watkin, B., Documents on Health and Social Services, 1834 to the Present Day. London, Methuen, 1975.

Webster, C., The Health Services since the War, Volumes 1 and 2. London, HMSO, 1988 and and The Stationery Office 1996.

Wohl, A. S., Endangered Lives. Public Health in Victorian Britain. London, Methuen, 1984.

Wrigley, E. A. and Schofield, R. S., The History of Population in England 1541 - 1871. London, Arnold, 1981.