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For public health, organizational issues have loomed large in this time period. Since the Victorian era, there has been friction between the ideas and methods of medical practitioners concerned with public health and those with other qualifications. In the 19th century this was exemplified by the conflict between Chadwick, a lawyer and Simon, a doctor, and between Simon and Florence Nightingale, a nurse. The Victorian era also provided an exemplar of the conflict of state authority and libertarian principles, and the view of public health practitioners who demonstrated the need for sanitary reforms which reduced the profit of landlords and unscrupulous employers. It is within this context of both inter-professional, intra-professional and professional versus governmental rivalry that these issues have to be viewed.

In the Victorian era public health tasks were clearly defined. Most public health doctors combined clinical practice with part-time, salaried public health duties.