Photograph of a large group of civic dignitaries standing at the edge of a new reservoir Show image info

The opening of Monkswood reservoir, Batheaston, 1895

Overview: who was responsible for public health?

Until the third quarter of the twentieth century, responsibility for public health lay almost entirely with Bath City Council or bodies closely linked to it. Since 1974, responsibility has been more widely shared. An overview of the bodies reponsible for public health at different periods is given below.

1. Medieval and early modern periods: Bath Corporation
Bath can trace its history back to the charter of 1189 by which it was created a royal borough, but throughout the medieval and early modern periods the borough corporation was concerned mainly with the property it owned and with maintaining the commercial interests of its tradesmen. ‘Public health’ in its modern meaning was not part of its functions or responsibilities. However, the corporation did provide a limited water supply to parts of the city from at least the sixteenth century.

2. 1766-1851: Bath [Improvement] Commissions 
During the eighteenth century, Bath grew from a small market and spa town into a fashionable resort for the aristocracy and gentry. The water supply the Corporation piped to parts of the city was a significant attraction to visitors, but the Corporation did not have the powers to provide other public health amenities such as paved streets, street lighting, rubbish removal and watching (policing). These were important issues both for the convenience of the inhabitants and for their high-class visitors. After other approaches met with limited success, the Corporation turned to the solution adopted by other cities: the setting up of independent commissions covering small areas, with powers to raise money for specific purposes. Five Acts of Parliament set up commissions as follows:

  • 1766 Bath Act, repealed and replaced by the 1814 Bath Act
    Both these Acts related only to the limited area covered by the borough, excluding the developing area of Outer Walcot, just to the north of the city centre.
  • 1789 Bath Improvement Act
    Again, this covered only the borough. Its main focus was the built environment rather than public health.
  • 1793 Walcot Act
    This Act covered the area of Walcot which was outside the borough; this area, just to the north of the city centre, included the Circus, Royal Crescent and other significant buildings which were developed from the mid-eighteenth century to accommodate the city’s fashionable residents and visitors.
  • 1801 Bathwick Act
    This Act covered the parish of Bathwick. To the east of the city centre, from which it was separated by the River Avon, Bathwick was developed as a fashionable suburb from the 1780s.

The composition of the different commissions varied, but all included representatives of the relevant parishes together with a small number of members of the Corporation. Their functions differed slightly, but included responsibility for street paving (and drainage), lighting, removal of ‘nuisances’ (rubbish) and ‘watching’ (policing), together with powers to compel compliance. Significantly, they were empowered to raise money from rates and loans.

3. 1851-1974: Bath City Council
The first national Public Health Act, passed in 1848 partly as a result of pressure from sanitary reformers, permitted the setting up of ‘Local Boards of Health’ to tackle issues of basic public health infrastructure. The City Council took the opportunity to constitute itself as the Local Board of Health for Bath in the Bath Act of 1851, adopting the provisions of the 1848 Act and adding some further Bath-specific provisions. The Council as Local Board of Health took over the functions of the different commissions, which were wound up.

Over the next century the role of the Council expanded greatly as various public health acts were passed, giving it responsibility or authority to act in a wide range of areas. By the mid-twentieth century, the Council was responsible not only for infrastructure such as water supply and sewers, but also for building standards and lodging houses; baths and washhouses; food standards; midwives and maternal, infant and child health; mental health; isolation hospitals; tuberculosis patients; and other health promotion and disease prevention measures.  As the responsibilities of the Council grew, it set up a number of committees and sub-committees to deal with specific aspects of public health.

The Council appointed its first Medical Officer of Health (MOH) in 1866. Originally a part-time appointment, the importance of the post grew under a series of influential post-holders as the public health responsibilities of the Council increased. The first full-time MOH was appointed in 1897; by 1944, the MOH had a staff of about 40, including several doctors.

As well as the Council, two other bodies had minor public health roles duriing this period:

  • The Board of Guardians of the Bath Poor Law Union
    From 1867 the Board of Guardians was responsible for administering vaccination to all infants, not just those in receipt of poor relief. The Council took over responsibility for all the functions of the Guardians, including vaccination, in 1930.
  • Magistrates’ Courts, mid-nineteenth to late twentieth centuries
    Magistrates courts were responsible for hearing cases of offences against public health bye-laws and food standards legislation. Cases were brought by the Police on behalf of the Council.

4. 1974 onwards: responsibilities split between various bodies
Major changes to local government and the National Health service took place in 1974, and responsibility for most public health functions were transferred from the Council to other bodies.

  • Water supply and sewers, 1974 to date: Wessex Water
    In 1974, responsibility for water supply and sewers passed to Wessex Water, one of the ten regional water authorities set up at this date.
  • Environmental services, 1974 to date: Bath City Council/Bath & North East Somerset Council
    Bath City Council (1974-1996) and its successor from 1996, Bath & North East Somerset Council, retained responsibility for environmental services such as waste collection, and for food standards.
  • Promotion of public health and health education, 1974-2012: Bath District Health Authority
    Responsibility for almost all public health functions other than infrastructure passed from Bath City Council to Bath District Health Authority in 1974
  • Promotion of public health and health education, 2013 to date: Bath & North East Somerset Council
    Under further changes to the NHS which came into force in 2013, responsibility for public health was returned from the NHS to the Council, and a Director of Public Health was appointed. However, the Council commissions rather than directly operates services.