Liverpool has always had many achievements to be proud of. In the field of health and welfare it has plenty of important achievements in which Liverpool people can truly say the city led the way. Unfortunately in the 19th and early 20th centuries Liverpool also led the way in terms of having the worst conditions in housing, health and sanitation. This situation was in part addressed by people like Doctor Duncan and Kitty Wilkinson. In 1842 the senior civil servant Edwin Chadwick published a report on the health of people in Britain. He examined the average age at death of different groups of people in different parts of the country. In rural areas the average age of death of a labourer was 41. In Liverpool it was a staggering 15 years of age! In many ways it was not surprising. Liverpool had grown as fast as any of the great cities which developed during Britain’s industrial revolution. The rise in population was much faster than the increase in housing, water supplies, sanitation and health care. Other records give us a clear indication of the impact of putting so many people in such cramped conditions without adequate facilities. Disease was common and deadly, and few diseases were feared as much as the cholera outbreaks which swept through British cities in the 1830s and 1840s and which broke out again from time to time.
Dr. Duncan was born in Seel street in 1805, the son of a Liverpool merchant. After his training he worked in Upper Parliament Street and Vauxhall. Duncan was much more than a doctor. He was aware that most health problems came from poor housing and sanitation. He contributed to investigations by Parliament into health issues. One of his most important contributions was his writing. In his 1843 pamphlet The Physical Causes of the High Mortality Rate in Liverpool, Duncan gave evidence on the conditions under which by far the greater part of the population of the borough lived. Typically 25% of his patients were living in cellar dwellings with between 15 and 30 people in an airless roomThe work of Duncan and other campaigners helped the civil servant Edwin Chadwick to promote the Health of Towns. Association in December 1844. Duncan established a Liverpool branch of the Association in April 1845. These advances led to the passing of the Liverpool Sanitary Act in 1846. This created Duncans future post as Medical Officer Of Health, the first such appointment by any city in the country. Duncan worked closely with another new man, James Newlands, the country's first Borough Engineer. Duncan remained Chief Medical Officer for the next 17 years.
James Newlands was born in Scotland in 1813 and died in Liverpool in 1871. As Borough Engineer he designed and installed Liverpool's first integrated sewer system. Working with Dr Duncan, he played a key role in improving public health through measures such as new building regulations, provision of parks, an efficient refuse collection system and street cleaning. He also fought hard to improve the access of people to clean water for drinking, and facilities such as public bath houses. During his lifetime he was well known. However, history seems to have remembered Dr Duncan more than Newlands.