If we look back, the foundations for a public health service could be said to have been laid in the 19th century when in 1834 the Poor Law Amendment Act called for the provision of sick wards in parish workhouses.

Although intended for the people in the workhouses, the wards soon became full with sick poor people from the parish in general, prompting the State to assess how best this situation could be dealt with.

In 1848, the Public Health Act created the General Board of Health, a centralised body intended to review and reform provision for public health but which, in fact, had little power to do so.

By mid-century, voluntary hospitals - which tended to be more exclusive since they had been created by the wealthy, charities and religious bodies and paid for by donations or subscriptions - began accepting some of the more complicated cases from the workhouses, indicating a further step towards public healthcare provision.

Another milestone during this time was the provision of separate institutional care for smallpox, fevers, insanity and tuberculosis; first in London and later in the provinces.