So recently as 1890 the state of the river below London was such as to be dangerous to the public health.
When the statutes relating to public health were consolidated and amended in 1875 London was excluded; and the law applicable to it was specially consolidated and amended in 1891.
The local sanitary authorities carry out the provisions of the Infectious Diseases (Notification and Prevention) Acts, which for London are embodied in the Public Health (London) Act 1891.
Metropolitan borough councils have to obtain the sanction of the Local Government Board to loans for baths, washhouses, public libraries, sanitary conveniences and certain other purposes under the Public Health Acts; for cemeteries the sanction of the Treasury is required, and for all other purposes that of the London County Council; poor law authorities, the metropolitan asylums board, the metropolitan water board and the central (unemployed) body require the sanction of the Local Government Board the receiver for the metropolitan police district that of the Home Office, and the London County Council that of parliament and the Treasury.
As a consequence the public health has improved, the highest death-rate in the years 1901-1907 being 29.6 per 1000.