After the 1848 cholera outbreak the board claimed the system was a success, Chadwick was quoted as saying “some 50,000 lives had been saved by the precaution”
. This was as a result of the door to door visitations and quarantining. Success also followed later, when in 1853 cholera was starting to make a comeback. Newcastle where it first took a hold saw on average 17 deaths per thousand, in comparison to Europe this was low as deaths per one thousand in Stockholm were 31, the same in Copenhagen, and 35 in Warsaw
. This can be attributed to the fact that Britain had health measures, Europe did not, in this relation the Public Health was a landmark as it was unique. However it was not a landmark in terms of its application. It had inherrent problems from the start; importantly the General Board of health did not have a permanent medical member until in 1850 when Dr Southwood was appointed. Dr Ramsay on the matter was quoted as saying “two lords and a barrister to preserve the health of the living; and then, after a year of doubtful success, calling in a physician to bury the dead?”
. Another problem was that large cities including Birmingham, Manchester, and Leeds did not appoint Medical Officers of Health until the late 1860s; this meant problems were not being properly looked into. The board simply did not have enough power, an example of this failing was when a pauper school in Tooting with 1400 pupils was seeing an average 14 to 20 deaths a day. The local unions were ordered to remove them but they inhumanely refused, with no legal powers the board was powerless and so the deaths continued
. The Board would instruct for measures to be taken when there was an outbreak but ignored tackling the causation. Sanitation the real issue was not properly looked into until 1869 when the Royal Sanitary commission was set-up. This was not just a problem with the board though it was with the population as well as there was the attitude that “People would not be bullied in to health and would rather take their chances with cholera”
. A lot of failings at the time can be attributed to this lack of knowledge; during the peak of decease in London in 1848 Chadwick ordered “no filth in the sewers - all in the river”
. This was of course the river Thames and was used as the main source of drinking water for the city. Altogether 250,000 died as a result of cholera, the government worked tirelessly to make deaths slow but had not been far reaching enough in its original legislation. Hygiene was not properly improved because the country had not been educated on the matter. The Public Health Act was the first of many, following in 1866,1871,1872 and 1875, it did start the ball rolling and so in this respect set a precedent and was a landmark, but was not as effective as hoped.
