One Hundred Years of Public Health

The 2010 NHS White Paper paved the way for responsibility for public health to transfer from the NHS to councils from 2013. Health issues have changed since councils last oversaw public health. This article from this months edition of Haringey People* looks at two public health reports – 100 years apart.


The past century has seen major public health advances, including in sanitation. One significant development in clean living conditions for Victorian London was the Markfield Beam Engine, at the former Tottenham sewage treatment works. It could pump four million gallons of sewage each day and today is a monument to Haringey’s health history.


One hundred years ago, Director of Public Health for Tottenham Urban District Council, Dr. David Kirkhope, served a population of 140,000. His 1912 report made reference to smallpox, while 38 infants were recorded as dying of whooping cough and 22 cases of childhood measles proved fatal.

Immunisation has played a major role in public health development, eradicating smallpox and reducing cases of whooping cough and measles. The 1912 report records two deaths from malnutrition, while 100 years on childhood obesity is one of the biggest health threats and the central theme of the 2012 Director of Public Health report.

By 2050, nearly 60 per cent of the UK population could be obese. Dr Jeanelle de Gruchy, Haringey’s director of public health, says: “One in five children in the borough aged between four and five are overweight or obese, this rises to more than one in three 10-to-11-year-olds; obesity is becoming ‘normal’. It is tragic that in 100 years we have gone from food being in short supply to an abundance of cheap, unhealthy food, which may prove just as damaging to life expectancy. The council will be looking at ways of tackling this with the support of local GPs.”

From April 2013, responsibility for public health will return to the council. Haringey has already set up a Health and Wellbeing Board and integrated the NHS public health team into the council.
Services commissioned by the council will include stop smoking services, NHS Healthchecks and sexual health. The changes will not include directly commissioning hospitals or GP practices, although the public health team will work closely with Haringey’s new Clinical Commissioning Group.

The 2012 report is available online at
www.haringey.gov.uk
(although I can't actually find a link to it Can you?). The 1912 report can be viewed by appointment at Bruce Castle Museum.

*yes, some of us read it

Original article printed in the May-June edition of Haringey People

Anyone who is interested in the history of public health might also like the exhibition at the Wellcome Collection on the work of pioneering Bermondsey Borough Council. The online part include some wonderful images of inter-war London and films that outline the aspirations of the day to make the population fitter and healthier: Here Comes Good Health