Placing the Public in Public Health in Post-War Britain, 1948–2012

146 Pages·2019·2.098 MB·English

by  Alex Mold

MEDICINE AND BIOMEDICAL SCIENCES IN
MODERN HISTORY
Placing the Public
in Public Health
in Post-War Britain,
1948–2012
Alex Mold · Peder Clark
Gareth Millward · Daisy Payling
Medicine and Biomedical Sciences
in Modern History
Series Editors
Carsten Timmermann
University of Manchester
Manchester, UK
Michael Worboys
University of Manchester
Manchester, UK
The aim of this series is to illuminate the development and impact of
medicine and the biomedical sciences in the modern era. The series was
founded by the late Professor John Pickstone, and its ambitions reflect
his commitment to the integrated study of medicine, science and tech-
nology in their contexts. He repeatedly commented that it was a pity
that the foundation discipline of the field, for which he popularized the
acronym ‘HSTM’ (History of Science, Technology and Medicine) had
been the history of science rather than the history of medicine. His point
was that historians of science had too often focused just on scientific
ideas and institutions, while historians of medicine always had to con-
sider the understanding, management and meanings of diseases in their
socio-economic, cultural, technological and political contexts. In the
event, most of the books in the series dealt with medicine and the bio-
medical sciences, and the changed series title reflects this. However, as
the new editors we share Professor Pickstone’s enthusiasm for the inte-
grated study of medicine, science and technology, encouraging studies
on biomedical science, translational medicine, clinical practice, disease
histories, medical technologies, medical specialisms and health policies.
The books in this series will present medicine and biomedical science
as crucial features of modern culture, analysing their economic, social
and political aspects, while not neglecting their expert content and con-
text. Our authors investigate the uses and consequences of technical
knowledge, and how it shaped, and was shaped by, particular economic,
social and political structures. In re-launching the Series, we hope to
build on its strengths but extend its geographical range beyond Western
Europe and North America. Medicine and Biomedical Sciences in Modern
History is intended to supply analysis and stimulate debate. All books are
based on searching historical study of topics which are important, not
least because they cut across conventional academic boundaries. They
should appeal not just to historians, nor just to medical practitioners, sci-
entists and engineers, but to all who are interested in the place of medi-
cine and biomedical sciences in modern history.
More information about this series at
http://www.palgrave.com/gp/series/15183
Alex Mold · Peder Clark ·
Gareth Millward · Daisy Payling
Placing the Public
in Public Health
in Post-War Britain,
1948–2012
Alex Mold Peder Clark
Centre for History in Public Health Centre for History in Public Health
London School of Hygiene & Tropical London School of Hygiene & Tropical
Medicine Medicine
London, UK London, UK
Gareth Millward Daisy Payling
Department of History Department of History
University of Warwick University of Essex
Coventry, UK Colchester, UK
Medicine and Biomedical Sciences in Modern History
ISBN 978-3-030-18684-5 ISBN 978-3-030-18685-2 (eBook)
https://doi.org/10.1007/978-3-030-18685-2
© The Editor(s) (if applicable) and The Author(s) 2019. This book is an open access publication.
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A
cknowledgements
The research that forms the basis of this book was conducted as part
of a Wellcome Trust Medical Humanities Investigator Award held by
Dr. Alex Mold. The project, ‘Placing the Public in Public Health: Public
Health in Britain, 1948–2010’, grant number WT 100586/Z/12/Z,
was based in the Centre for History in Public Health at the London
School of Hygiene and Tropical Medicine (LSHTM). The project was
made up initially of four strands and each was the primary responsibil-
ity of one member of the team. The strands and staff were: the place
of the public in health education and health promotion (Alex Mold);
health surveys, public opinion and the public’s health (Daisy Payling);
chronic disease, with a focus on coronary heart disease (Peder Clark);
and infectious disease, with a focus on vaccination (Gareth Millward).
A fifth strand, on public health and emotion (Hannah Elizabeth), was
later added to the project, but the research from this work came too late
to feature in this book.
Like the project on which it is based, this book is very much a col-
laborative endeavour. Alex Mold took the lead in framing the book and
the chapters, and the main body of the book was written together. The
fact that this was a relatively smooth process is a testament to the team,
but also to the support we received from a number of key individuals
and institutions. Hannah Elizabeth has been this book’s best ‘critical
friend’, pushing us and our work in exciting new directions. Ingrid James
has supported us in making this research happen and resolved innu-
merable practical problems with exemplary calm. Our other colleagues
v
vi ACKNOWLEDGEMENTS
in the Centre for History in Public Health, especially Virginia Berridge,
Martin Gorsky, Chris Sirrs, John Manton, Hayley Brown, Erica Nelson,
Janet Weston, Sue Taylor, Mateusz Zatonski, Ros Stanwell Smith and
Anne Hardy have been hugely helpful, providing advice and guidance
throughout the duration of the project. We were also supported by our
project advisory group, the members of which included Professor David
Evans from the University of the West of England; Professor Sally Sheard
from the University of Liverpool; the archives team at the LSHTM and
Erin Lafferty, the School’s Public Engagement Coordinator.
Away from the LSHTM, we are grateful to the audiences at the con-
ferences and seminars where members of the team spoke about this
research. There are too many to list in detail here, but special thanks
to audiences at the Society for the Social History of Medicine confer-
ences in Oxford, Kent and Liverpool; the European Association for the
History of Medicine and Health conference at Lisbon and Bucharest;
and the meetings of the NHS ‘tribe’ of Wellcome funded projects on
similar topics at the universities of Warwick and Liverpool. These meet-
ings were particularly helpful in enabling us to speak to researchers work-
ing on similar themes but in different places and contexts.
Archives and libraries remain essential to the work of the contempo-
rary historian. We would like to thank the staff at the National Archives,
the British Library, the Wellcome Library and Archives and the library
and archives staff at the LSHTM.
We are grateful to the history publishing team at Palgrave, especially
Molly Beck and also to Tom Crook who provided insightful comments
on the manuscript.
All of us have been supported by family and friends during the
research and writing of this book. There are simply too many people to
name—but you know who you are!
Finally, we would like to thank the Wellcome Trust, not only for the
grant that allowed this research to happen, but also for being a support-
ive funder throughout the research process.
c
ontents
1 Introduction 1
1 Outline of the Book 4
Bibliography 6
2 The Public and Public Health 7
1 The Public 8
2 Public Health 14
3 The Changing Relationship Between Public Health and the
Public 21
4 Conclusion 26
Bibliography 26
3 Imagining Publics 33
1 Public Population 35
=
2 The Public Groups 40
=
3 Public Individual Behaviours 51
=
4 Conclusion 58
Archival Material 59
Bibliography 59
4 Speaking Back 67
1 Resistance 68
2 Complaints 77
vii
viii CONTENTS
3 Reinterpretation and Appropriation 82
4 Conclusion 91
Archival Material 92
Bibliography 93
5 Changing Publicness 99
1 Private 100
2 Public 106
3 Beyond Public and Private 115
4 Conclusion 121
Archival Material 122
Bibliography 122
6 Conclusion 131
1 The Place of the Public 132
2 The Nature of Public Health 133
3 The Relationship Between the Public and Public Health 134
Bibliography 136
Index 139
CHAPTER1
Introduction
Abstract TheIntroductionsetsoutthekeyquestionstobeexplored,sum-
marisesthemainargumentsanddescribesthecase-studiesusedtoconsider
theseissuesindepth.Whatwastheplaceofthepublicinpublichealthin
post-warBritain?Howdidthischangeovertime,andwhydoesthismatter?
We briefly describe how we go about answering such questions by intro-
ducingthereadertoourcase-studyareas.Theseare:thechangingnatureof
health education; the public health survey; the response to heart disease;
and the development of vaccination policy and practice. We also set out
whateachchapterwillcoverandargue.
Keywords Thepublic·Publichealth·Publichealthhistory
In July 2006, the Labour Prime Minister Tony Blair gave a speech on
healthy living. He began by stating that ‘Today I focus on what we call
“publichealth”butwhichisreallyabout“healthyliving”’.Blairwentonto
setoutthechallengestopublichealthashesawthem.Heassertedthat‘Our
public health problems are not, strictly speaking, public health questions
atall.Theyarequestionsofindividuallifestyle-obesity,smoking,alcohol
abuse, diabetes, sexually transmitted disease’. Whose responsibility, Blair
pondered,wasittodealwithsuchproblems?Theanswer,heargued,was
that‘Governmentshouldplayanactiveroleinthewaytheenablingstate
©TheAuthor(s)2019 1
A.Moldetal.,PlacingthePublicinPublicHealthinPost-WarBritain,
1948–2012,MedicineandBiomedicalSciencesinModernHistory,
https://doi.org/10.1007/978-3-030-18685-2_1