Royal Commission on the Poor Laws and Relief of Distress. Appendix.

  • Great Britain. Royal Commission on the Poor Laws and Relief of Distress.
Date:
1909-1913
Catalogue details

Licence: Public Domain Mark

Credit: Royal Commission on the Poor Laws and Relief of Distress. Appendix. Source: Wellcome Collection.

    484/646 (page 474)
    Fuller. 24 April 1906. Security of tenure of Medical Officer. Function of Local Government Board as to salaries of Medical Officers. Concerted action by Medical Officers as to inadequacy of their salaries. Cases of Bangor and Aberyst with 474 MINUTES OF repayment of the salary in the case of the ordinary visiting medical officers or the district medical officers. 10616. Somewhat on the principle which has been adopted in the case of other medical services ?—Yes, par- ticularly in the case of the public health. 10617. (Mrs. Bosanquet.) I do not quite understand what repayment of the salary means here ?—That instead of becoming a local charge, part payment is made out of, I believe, the national funds and part payment out of the local funds. 10618. (Dr. Downes.) By a grant-in-aid ?—It practi- cally amounts to a grant-in-aid. 10619. (Mr. Gardiner.) In return for that the medical officers of health cannot be got rid of except with the consent of the Local Government Board, I think; they are protected by the Local Government Board in con- sequence, are they not ?—I should say so, but I am speaking off the book there. 10620. (Dr. Downes.) The Poor Law officer, I believe, is not removable except with the consent of the Local Government Board ?—That is so. 10621. His appointment is also subject to the approval of the Local Government Board, is it not ?—I think it is, in so far as approving of the payment of the salary; I do not know that the Local Government Board ever ex- ercise any discretionary power as to the appointment of the individual qua the individual. 10622. There is a formal approval, is there not ?—Yes, there is. 10623. The salary is practically fixed by the guardians ? —I believe so in almost all cases. 10624. I am speaking of the provinces ?—In the provinces it is so. 10625. What power would the Local Government Board have to regulate any salary in the provinces, if the guardians were unwilling to do so themselves; are you aware of any ?—I am not aware of any, except a power of suggestion and personal interview on the part of the general inspector. 10626. Such powers as are in the possession of the Local Government Board for that purpose are not ot a practical character ?—I think not, 10627. In regard to the questions that were asked you about the salaries of medical officers being regulated by the Local Government Board, I dare say you are aware that in London there is a fund known as the Common Poor Fund ?—Yes. 10628. Which places the matter on really a different footing, I think ?—I believe so. 10629. In paragraph 25 of your memorandum, to which we have just been referring, you attribute the unsatis- factory state of the salaries in some cases to the want of cohesion of the medical profession as a working body of men; am [I right in supposing that there have lately been certain cases in which there has been more cohesion on their part ?—I think that the tendency is now more towards establishing a ‘‘trade unionism,” as it were, among medical men in relation to these appointments. 10630. There is a case at the present time, is there not; it has been reported in the public press, so there is no secrecy about it ?—There are two cases. One is the case of the medical officer for the workhouse in the Aberystwith Union, and the other is the case of the medical officer for the Bangor workhouse. 10631. They are both matters of public knowledge, are they not ?—They are. 10632. Will you shortly state what the facts are in those cases ?—At Aberystwith, the medical officer, I believe, was in receipt of a salary of £30 a year; he asked for an increase, and the guardians declined to give it, without giving any reason. The medical officer, as a protest, resigned. Then the guardians asked him to resign all his other Poor Law appointments ; he refused, and the Local Government Board supported him in that refusal, 10633. Have the guardians appointed anybody to the workhouse ?—As a temporary measure they came to terms with the local voluntary hospital committee to allow their house surgeon to ope at the workhouse EVIDENCE : of this month, and, as far as one knows, there is no other possible arrangement to be made. 10634. Do you know whether the British Medical Association have taken any action in the matter ?—The British Medical Association took action from the very beginning, and, I believe, wrote through the secretary of the Local Association to all the medical men in prac- tice in the district, asking them not to apply for the appointment. 10635. (Mr. Patten-MacDoujall.) Is the appointment that of the workhouse medical officer ?—Yes. 10636. How many inmates are there in that work- house ?—About seventy, I think. It is some time since I visited Aberystwith, so I am not quite sure about the numbers. The numbers in Knight’s Directory do not always correspond with the actual numbers in the house. 10637. (Dr. Downes.) It is not a very large place, is it ?—No. 10638. I do not know whether you would care to give the details of the Bangor case ?—The Bangor case is one where the medical officer had to resign for various reasons; I think the Local Government Board called upon him to resign. The guardians offered what the British Medical Association, that is, the local association, considered an inadequate salary. There again, repre- sentations were made to all the local medical men not to apply for the appointment, and no one applied. The guardians have now re-advertised the appointment, with an increase of £20, and the local association con- sider that £70 per annum, which is now offered, is an adequate salary, so there is no restriction, or no sug- gested restriction, upon application. 10639. So that there are two recent cases in which there appears to be some action on the part of the medical profession as an organised body ?—In the provinces ; I believe those are the only two cases that have happened during my term of office as medical inspector. 10640. You had, previous to your appointment, SOME Fefact of experience of out-door medical relief; have you Medical any recollection of any change which followed the Relief passing of the Medical Relief Disqualification .Re- Disqualifi moval Act ?—Yes. In the first twelve months of my tion appointment the number of cases that I had to see as a Removal district medical officer amounted to twelve or thirteen in the course of the week, but these gradually mounted up till I had a list of twenty-five to thirty cases. Then I wrote a protest to the local authorities, saying that I did not consider some of these cases should be treated . as out medical relief cases, and they replied with a sug- gestion that I should apply for an increase of salary, and I did so. I was informed by the clerk to that union that the guardians did not consider that any opinion of mine as to whether these cases should be treated as out medical relief cases came within my province, as I was not a relieving officer. 10641. To what did you attribute that increase in the number of cases ?—To the passing of the Act to prevent medical relief disqualifying a person from voting. That Act was passed in 1885. Rightly or wrongly, I put it down to that; not that it happened within the next year—I believe it was two years after the passing of the Act—but it became known that it did not disqualify about that time in that particular union. 10642. Do you know whether it was that the people applied more readily or that the orders were given more readily ?—I think that it was both. It gradually be- came known that the Guardians did not refuse, neither did their relieving officer refuse to give orders for out medical relief. 10643. On the question of the separation of the in- Workhous firmary administration from the workhouse, in your ex- eee 8 perience you have had to deal with infirmaries admin- separa ‘ istered on quite a different basis, have you not ?—Yes. qministra 10644. Are not some of the largest infirmaries and 4- some of the best in the provinces administered without any order other than the General Consolidated Order 7 —Yes. I have mentioned one in particular, the Crump- sall workhouse infirmary—the infirmary in Manchester township. There is no order relating to the administra-