Public health at its peak— the interwar years

Abstract

Abstract This chapter picks up the evolution of public health in the United Kingdom in the period immediately following the First World War. The scene for initial optimism and ambition was set by the goals for reconstruction after the Great War which drove the move for ‘Homes Fit for Heroes’. The demand for resources distracted from the progress that was being made in bringing public health and health care together. Progress was made in organizational development, the appointment of the first Chief Medical Officer in the Department of Health, and the construction of pioneering health centres. The stock market crash and the recession that followed halted progress until the threats of fascism galvanized action in the public sector. The chapter also covers the evolution of public health from the sanitary movement of the 1840s, through the focus on hygiene at the end of the nineteenth century, to the therapeutic era, which began in the 1930s. The origins of the New Public Health, with the central role of the World Health Organization and the convergent thinking from North America and Europe, is described. The tension between hospital-dominated medicine and the preventive orientation of public health is explored. The emergence of a consensus for transformational change to health systems rooted in public health is chronicled. At the heart is a need to reconcile primary care and public health in the face of new challenges. The shift to multidisciplinary working is underlined.