Many of the world’s modern systems of public health surveillance have their origins in innovations Britain introduced in the mid-19th century, including continuous water supply, sewage filtration and routine governmental investigation of disease outbreaks.

And yet Britain has never managed to eradicate systemic failures when it comes to providing safe, clean and accessible drinking water to its citizens. To understand why not, we need to start by revisiting Britain’s major cholera and typhoid outbreaks of the 19th- and early 20th-century, which at their peaks killed hundreds of people every day.

‘The power of life and death’

The colossal power of life and death wielded by a water company supplying half a million customers is something for which, till recently, there has been no precedent in the history of the world. Such a power ought most sedulously to be guarded against abuse.

These prophetic words were written by the British government’s first ever chief medical officer, John Simon, in 1867. He was responding to one of the country’s worst water-related scandals: the 1866 cholera epidemic that killed 5,596 people in the East End of London.

Globally, the full-scale water privatisation of England and Wales remains an exception, other than for a few World Bank-led initiatives in developing economies. Most European countries have opted for a coexistence of private and public bodies.

In England and Wales, selling off water providers as regional monopolies led to unsustainable price hikes, with company after company prioritising shareholders over customers from the get-go.