Public measures

At first the government tried - as the Romans had done - to prevent illness among the population by public sanitation measures.

The first public health measures were based upon the idea that miasmas caused disease. Although the idea was wrong, the measures against the miasmas involved a greater focus on cleanliness, and this improved public health.

Further measures included:

• In 1848 the first Public Health Act caused the setting up of a Board of Health, and gave towns the right to appoint a Medical Officer of Health.
• In 1853 vaccination against smallpox was made compulsory.
• In 1854 improvements in hospital hygiene were introduced (thanks in large part to Florence Nightingale).
• In 1875 a Public Health Act enforced laws about slum clearance, provision of sewers and clean water, and the removal of nuisances.

The benefits of these measures soon became clear, and by the late 19th century local councils were competing with each other to provide the best public health.