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Public health in Scotland continues to evolve and adapt. Here’s our timeline which explores the accomplishments, milestones, innovations and breakthroughs that help tell the story of public health and its challenges in Scotland and how we are now in the ‘Fifth Wave’ of public health.

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Wave 1

Wave 1 - 1830-1900

Structural, classic public health interventions, such as water and sanitation, safer working conditions, beginning of police force.

1800 Glasgow forms first City Constabulary.

Showing pictures of Cholera Epidemic Edinburgh.

Publication of Facts and Observations on the Sanitary State of Glasgow. 1844

The report by Dr. Robert Perry M.D. found an early link between poverty, disease and crime.

Scottish Registration Act—ended ecclesiastic reporting of deaths and births and introduced civil registration which allowed for the government to begin to ‘track’ population health.

Henry Duncan Littlejohn publishes a Report on the Sanitary Conditions of Edinburgh.

Scotland Vaccination Act 

The landmark report, the first of its kind, analysed the sanitary conditions of different regions of the city—the end result was that future sanitation policies were decided by the cities’ council committees by evidence rather then by word of mouth.

1867 - Public Health Scotland Act

The Act allowed local authorities to be able to appoint ‘Medical Officers of Health.’ It would be amended in 1871, 1875 & 1882.

Education Scotland Act passed creating around 1000 Regional School Boards which took over Scotland’s Kirk schools.

Wave 2

Wave 2

National Insurance Act

Scotland’s First Housing Act passed, promising government subsidies to help build 500,000 houses within three years. Due to economic pressures, only 213,000 homes were completed.

Portable x-ray lorries allow for tuberculosis testing

1890-1950 - Biomedical, Antibiotics and Early Vaccines.

The Royal Victoria Hospital, the first tuberculosis sanatorium in Edinburgh, opens.

Created national insurance— although spear—marked originally for industrial workers, it is widely considered the foundation of the modern welfare state.

Education Scotland Act introduced free secondary education to the children of Scotland.

Penicillin, the first antibiotic, was discovered by Alexander Fleming. It would be given to the wider Scottish population during and after World War 2.

Wave 3

Wave 3 - 1940-1980

Clinical, Lifestyle-related diseases.

Department for Health of Scotland lead programme to increase the number of Emergency hospital services in Scotland during the Second World War.

Publication of the Beveridge Report.

Liberal economist Sir William Beveridge published a report that called for the banishment - from Britain of the ‘Five Giants: Usittf gas want, ignorance, squalor, idleness and disease.’ Report by WILLIAM IIE'ISRIMI

1948 - NHS Service
Founded The National Health Service (Scotland) Act 1947 came into effect on 5 July 1948. One National Health Service was created for England and Wales and was accountable to the Secretary of State for Health. There were a separate NHS created for Scotland and was accountable to the Secretary of State for Scotland —who was at the time, the Right Honourable
Arthur Woodburn. Many sections of the act went on to be repealed in 1972 and again in 1978.

Smallpox outbreak in Glasgow.

Study by Sir Richard Doll and Sir Austin Bradford Hill shows a link between smoking and the development of lung cancer.

At the time of the report an
estimated 86% of British adults
smoked. Today an estimated
15.9% smoke in Scotland. Although
smoking rates are still highest

in the most deprived areas, with
35% of people living in the most
deprived areas of Scotland smoking
compared to 10% in the least
deprived areas.

Wave 4

Wave 4


Social determinants of health, risk factors, lifestyle, the emergence of the understanding of inequalities in health as the disease continues Scotland produces a wide array of HIV public health campaigns.

Black report published. Highlights the growing health gap between rich and poor in Britain, despite 1980 NHS and investment in the welfare state.

Community Care and Mental Health Rolled out. Closure of large, long-stay hospitals for people with mental health problems and learning disabilities.

Care and Health Scotland 

Bill Scottish Executive introduced the Community. The Bill proposed changes to the delivery of residential and non-residential care services and provisions for free nursing and personal care for the elderly as well as other measures related to community care.

The Smoking, Health and Social Care (Scotland) Act.

The Scottish Parliament Act which went into effect from 26 March 2006, prohibits smoking in wholly or ‘substantially enclosed spaces’ in Scotland.

The action plan Better Health, Better Care is introduced and sets out the government’s plan to improve the nation’s health by helping people in disadvantaged communities have better access to health care.

Scotland joins Northern Ireland and Wales in abolishing prescription fees.

Wave 5

Wave 5

201 O-ongoing Culture change and new ways of working involving the creation of essential partnerships between local, regional and national bodies in order to promote a culture of health in Scotland.

Christie Commission Report Published.

Report on the future delivery of public services chaired by Dr Campbell Christie is published setting a need for systemic public health reform in Scotland. 

Review of Public Health in Scotland is Published.

The Review recognised the need for public health reform, new ways of working across the whole system and the need for a new national health organisation, Public Health Scotland.

2013 Scotland’s Six Public Health Priorities Published.

In recognition of the health challenges facing Scotland, COSLA and national government agree on a set of six public health priorities for the future. Public Health Scotland, the new national agency for public health, launches The organisation, formed by COSLA and national government, will use Whole System working, data and intelligence and dynamic leadership
to tackle Scotland’s health challenges.