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The primary duty of the Commission was to provide lighting in the towns, initiating building programmes, as well as water supplies, the management of sewerage, repairing roads and prohibiting nuisances.

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.

Elizabeth 'Bess' Berry was the fourth child and second daughter of Edward and Margaret Crow of Tullamore. In 1812, she married Robert Fleetwood Berry who died in 1822. She died in 1848 and was buried at Eglish.