The Royal Commission on The Poor Laws and Relief of Distress

Before the creation of the Ministry of Health in 1919 and the subsequent introduction of the National Health Service in the late 1940s the health of the United Kingdom was underpinned by the Poor Laws. These laws date back to Tudor times but were overhauled several times since then, with the last revision between 1905 and 1910. As healthcare was decentralised there was a worry that needs were not being met in a consistent way, especially as care was administered by several different factions and poor relief was not shared equally between rich and poor areas. The result of this investigation was the Royal Commission on The Poor Laws and Relief of Distress, with various professionals being called to give evidence on the types of healthcare available to people across the country.

The three-page excerpt below is part of the oral evidence submitted by Dr James Spottiswoode Cameron, Medical Officer of Health for Leeds. As you can see, the commentary is varied, covering subjects such as milk, tuberculosis, and treatment from religious groups. This publication is part of the DHSC collection at Quarry House.

It’s interesting to see the types of diseases that Dr Spottiswoode Cameron mentions in his descriptions of Leeds as they’re very different to ailments we would recognise today. There’s mention of a smallpox outbreak on the Killingbeck Estate and how twenty beds in Seacroft hospital were reserved specifically for diphtheria patients.

There is detail about where medical professionals work in the city, whether within the police force, or through friendly societies and religious charities, like the Leeds Jewish Hospital and Leeds Catholic Home For The Aged.

Ultimately, the First War and its effects on the population derailed many of the recommendations from the final report, with the Poor Laws being subsumed into the work done by the Ministry of Health. Various laws were passed to alleviate unemployment and provide support for people who needed it. In the 1930s, local government was reorganised, and money was injected into depressed areas, with an emphasis on the protection of British industry. However, Dr Spottiswoode Cameron’s evidence provides a valuable insight into the state of healthcare in Leeds in and around 1910.
The Cabinet Papers | The Poor Law and Ministry of Health (

The Department of Health and Social Care
Dr James Spottiswoode once gave evidence about a typhus outbreak in the slums of Quarry Hill, which is where the Department of Health and Social Care (DHSC) is partly based today. Quarry House holds DHSC’s physical library and the Knowledge Centre provides library resources to DHSC staff, helping them to carry out analysis and develop policy.

Librarians often get involved at the beginning of a policy journey, conducting literature searches to find out what evidence already exists. Topics can be on very specific healthcare subjects such as pulse oximeters or tobacco packaging or much more wide-ranging, covering subjects such as the effect of climate change on health and the nursing workforce.