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Boards of public health and assistance were formally set up in 1924 under the provisions of the Local Government (Temporary Provisions), Act, 1923. However, the process of setting up the boards of health and public assistance was initiated during the War of Independence when local government in the form of county councils nationwide, ceded political control to republicans in the 1920 local elections. Declaring the abolition of the English poor law system and its workhouses as a major policy objective, the newly elected councils proceeded to wind down the boards of guardians who oversaw the administration of poor law by the end of 1921. In the interim period before the establishment of the Free State and the passing of the 1923 enabling legislation, a process known as ‘Amalgamation’ took place, which attempted to reduce the number of institutions in each county on the grounds of economy and efficiency.

In Offaly, the semi-independent King’s County Infirmary was closed in 1921. The three workhouses in Tullamore, Edenderry, and Birr, were also closed in 1921, the building in Tullamore being repurposed into a county home to accommodate the aged and infirm, the destitute poor, invalids, and unmarried mothers and their children. It also provided maternity services. The old workhouse infirmary was repurposed into the county hospital for medical and surgical services transferred from the closed King’s County Infirmary. There was a separate fever hospital on the same site. In Edenderry, a district hospital was established in the old fever hospital attached to the former workhouse. In Birr, the workhouse infirmary was used as a sanatorium for tuberculosis patients, and the district hospital for the Birr area was in the old fever hospital. In the 1930s, Hospital Sweepstakes money funded the construction of a new county hospital at Tullamore and further improvements to the local hospital network.

The responsibilities of the boards of health and public assistance were wide ranging and included poor relief, administration of hospitals and homes, services to the sick poor, maternity services, and services to unmarried mothers. They also had responsibility for public health, sanitation, disease control, water supply, and certain services formerly carried out by the rural district councils, which were dissolved in 1925.

The board was a charge on the county and board members, who had executive functions, were appointed by the county council. A series of legislative changes changed the role and function of the board. In 1942, the enactment of the Public Assistance Act, 1939 formerly replaced the poor relief acts of the nineteenth century, and combined central control exercised by the Minister for Local Government and Public Health, with local administration. At this point, the board came fully under the control of the county council and the executive functions transferred to the County Manager.

The Health Act, 1947 made county councils health authorities in their own areas. The Health Act, 1953 transferred hospitals and institutions to health authorities, thereby separating public assistance from the treatment of the sick. The Health Act, 1970 set up eight regional health boards, transferring health services from county councils, Offaly falling under the jurisdiction of the Midland Health Board. The Social Welfare (Supplementary Welfare Allowances) Act, 1975 transferred the administration of public assistance to the health boards, which were set up in 1970. This completed the transfer of responsibilities in the area of public health and public assistance from local authorities to central government.

Robert Fleetwood Berry was born on the 1st January 1777, the twelfth child and seventh son of Thomas and Frances Berry of Eglish Castle near Birr. As a young man, he was apprenticed, from 1793 until some time after 1801 to Mr John Brennard, a cotton merchant and draper, of Castle Street, Liverpool. By 1804, he lived in Ireland and was employed in the linen business in Dublin. In 1812 was living at Gallen, King's County, being employed in connection with the Grand Canal. On the 14th of November of that year he married Elizabeth Crow at St. Catherine’s Church, Tullamore. She was the daughter of Edward Crow of the Round House, Cromac Street, Tullamore. After their marriage they lived at Shannon Harbour. He died there suddenly on the 21st August 1822 and was buried in the Berry enclosure in the graveyard of the Church of Ireland Church at Eglish, King's County.

Frances Berry was born in 1743, and was the only child of Knight Berry of Birr and Eglish and his wife Sophia, daughter of Captain James Sterling of Whigsborough. In 1759 she married Thomas Berry. They lived at Eglish Castle and had sixteen children. Frances Berry died in 1807 and is buried at Eglish.

Sterling Berry was born in 1771, the ninth child and fifth son of Thomas and Frances Berry of Eglish. He married in 1806 and died in 1828.

Catherine Maria Dawson was the daughter of Thomas Townley Dawson and married firstly James Tisdall, and had two children by him, James Thomas Townley Tisdall and Louisa Tisdall. She married Charles Bury in 1798 shortly after the death of James Tisdall from epilepsy. They had one son, Charles William, who succeeded his father in 1835.

Her daughter by her first marriage, Louisa Tisdall (1796-1882), married George Marlay, and many years later in 1912, her grandson, Charles Brinsley Marlay, bequeathed his estate at Belvedere, Mullingar, County Westmeath to his distant cousin Charles Kenneth Howard-Bury. Charles Brinsley Marlay also inherited Catherine Maria's papers which are now housed in the University of Nottingham.

Harriet Charlotte Beaujolois Cambell, third daughter of Col John Campbell and Lady Charlotte Campbell, married the 2nd earl of Charleville in Florence in 1826. She enjoyed writing and her travel diary 'A Journey to Florence in 1817' which was written when she was a teenager, was published in 1951 following its discovery in a London bookshop. Her mother, Lady Charlotte Susan Maria Campbell (later Lady Charlotte Bury after a second marriage), was also a writer. Harriet had five children with Charles William, two of whom would succeed to the earldom: her eldest son, Charles William George and her third eldest son, Alfred, who succeeded as the 5th earl of Charleville when his nephew died in 1874. She died in Naples in 1848, predeceasing her husband by three years.

Charles William Bury inherited the Charleville estate when he was a mere 6 months old. His father, John Bury (1735-64), drowned four months after inheriting Charleville from his maternal uncle, Charles Moore (1712-64), earl of Charleville (of the 1st creation). The estate was several thousand hectares in size and included the town of Tullamore. In 1785, Bury reached the age of 21, graduated with a BA from Trinity College Dublin and returned to Tullamore which had been partially destroyed after the great balloon fire of that year. He granted new leases in the town and brought about its rapid development. He employed Francis Johnston to design three major landmarks in Tullamore: St Catherine’s Church, the Market House, and the Gothic fairytale castle, Charleville Forest, which was set in 1500 acres of woodland.
In his political career he was returned MP for Kilmallock in 1789-90 and again in 1791-7. He became Baron Tullamore on 26 November 1797, Viscount Charleville on 29 December 1800, and 1st earl of Charleville (of the 2nd creation) 16 February 1806.
He was elected a fellow of the Royal Society in 1803 and a fellow of the Society of Arts in 1814. He published a paper in the RIA’s Transactions in 1799 on the subject of turf ash and became president of the academy from 1812-1822.

Marjorie Howard-Bury was the only daughter of Lady Emily Howard-Bury and her husband Capt. Kenneth Howard-Bury. She died at 22 years of age and there is a memorial to her at St Catherine's Church, Tullamore.