But several of the Boards of Guardians took no notice of the instructions sent them; others sent unsatisfactory replies. In not one of the parishes in which the epidemic was most fatal was the preventive machinery, sanitary and medical, organised in accordance with the instructions; and although some parishes did more than others, yet, speaking generally, the administration of the sanitary and medical relief measures by the Boards of Guardians was inefficient in character and extent, except in some of the larger and more healthy parishes where they were least wanted.[51]
At Rotherhithe, the Guardians declined to proceed with the removal of nuisances as entailing a useless expense. At Deptford, where cholera was at the worst, no Inspector of Nuisances was appointed, even for the emergency. Nor did Greenwich, where it was also bad, appoint one. In Bethnal Green, where memories ought to have been bitter, the authorities practically did nothing, although promising almost everything.
In Lambeth, the parish was left without any adequate protection against the epidemic; and it was only after urgent remonstrances by the Medical Inspector, and after his threatening to place himself in communication with the coroner in any cases of death occurring in localities where the proper cleansing measures had not been carried out, that he succeeded in obtaining the adoption of measures even to a limited extent.[52]
In Clerkenwell, the Guardians utterly disregarded the recommendations of the Board of Health, and from the first there was an openly expressed determination not in any way to be interfered with by the Board.
And the disastrous state of affairs was, that the Nuisances, &c., Removal Acts gave the Board of Health no power to enforce upon the Guardians the execution of the regulations made.
The whole sanitary administration—so far as any existed in London—was in a state of chaos, and the various local authorities were able, with absolute impunity to themselves, to ignore and even defy the General Board of Health. Of these authorities, as has been already said, there was a multiplicity, and it was no infrequent occurrence to find the administrative authority of some of them in the hands of parties directly interested in the continuance of the existing state of matters, evil though those were. In fact, the “vested interests in filth and dirt” were a power in local administration in “greater London,” and the practical result was that the great majority of the population of the metropolis were left without any protection against the ravages of epidemic or other preventable diseases.
The indifference of Parliament, moreover, had left London without any effective or systematic sanitary supervision; and in no part of it, except the “City,” was there any officer conversant with the effect of local influences on the health of the population, or who could advise as to the sanitary measures which should be adopted.
The Board of Health having had it brought home to them that, with their limited powers, they were unable to introduce order into this chaos, or to enforce even the most elementary precautions against the spread of the disease, their President addressed a letter on the 29th of January, 1855, to Lord Palmerston, the then Home Secretary (and a few weeks later the Prime Minister), in which he set forth the exact state of affairs as ascertained by his own observation and by the experience of some of the best and most well-informed medical men in London.
In this letter he summarised the main causes of the insanitary condition in which the people of London were forced to live.