Return to an order of the House of Commons, dated 5 Aug., 1874, for copy of reports of local government board inspectors on the working of the public health act, 1872 / Local Government Board, 25th March, 1875, H. Fleming, Secretary.

  • Great Britain. Local Government Board.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: Return to an order of the House of Commons, dated 5 Aug., 1874, for copy of reports of local government board inspectors on the working of the public health act, 1872 / Local Government Board, 25th March, 1875, H. Fleming, Secretary. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    No. 2 District. I commenced a tour of visits in October 1872 ; and as the Board had provided me with an assistant to undertake the ordinary workhouse inspection, I was J He°le Es enabled to devote my whole time to this special duty. ' ' The persons who shall be appointed clerk and treasurer to the newly-consti- tuted authorities being prescribed in the Act, it was only necessary to consider the appointment of a medical officer of health, an inspector of nuisances, and such other officers and servants as it (the authority) may deem necessaiy for the efficient execution of the purposes of the Sanitary Acts. As regards the officer of health, the Act allows each rural sanitary authority discretionary power to adopt one of the following courses :— To appoint one such officer, or more than one, for its own district alone ; To unite, with the sanction of the Local Government Board, in appoint- ing the same person as officer of health for two or more sanitary districts, by the joint or several appointment of the sanitary authorities of such districts ; To appoint, also with the sanction of the Local Government Board, the district medical officers of the union, or any one of them, to be officer or officers of health for the sanitary district. In determining which of these courses each authority should adopt, the inti- mate relations, based upon constant official and personal intercourse, which subsisted between Boards of Guardians and the general inspectors of the Local Government Board, placed the latter in an advantageous position for offering advice, and making suggestions with a prospect of being listened to; but they were not invested as regards the new work in hand with the exercise of any special functions other than those with whicii the authorities with whom they had to deal had long been familiar. The appointment of the various district medical officers to be officers of health each in his own district, was a course specially suggested in the Report of the Royal Sanitary Commission,* and was one which probably recommended itself to many Boards of Guardians as the least onerous, and apparently the most economical mode, of complying with the requirements of the Act. Nor has it ever been questioned that the district medical officer is in a position to acquire a vast amount of local information which it is highly desirable that the officer of health should in one way or other be put in possession of; and it might naturally occur to many that the readiest mode of utilising this information for sanitary purposes would be to constitute the same person both district officer and officer of health. On the other hand, it is argued that the district medical officer cannot in all, or even in most cases, be expected to possess the standing and requirements necessary for the effective discharge of the duties of a medical sanitary officer; to which it is added, that were he ever so efficient, personally, his position would always preclude a district medical officer from being inde- pendent of local influences, and that such independence is an essential qualifica- tion in an officer of health. Obviously, also, the appointment of the district medical officer would be incompatible with the views of those who hold that the officer of health should be required to devote his whole time to the duties of his office, and should be debarred from engaging in private practice, the engrossing duties of which, in the case of most country doctors, would leave but a small margin of time for sanitary inquiries. Boards of Guardians in search of scientific opinions to guide them to a decision would find both sides of the question ably advocated by eminent professional authorities; and it is not sur- prising if, with the express suggestion of the Royal Commission before their eyes, they in some instances adopted a course in favour of which much had been said, and appointed as officers of health the men whom they had ready to hand in the several medical districts, and with whom they were personally acquainted. The appointment of a single officer of health for the whole of a rural sanitary district, seems likewise open to serious objections. The person appointed must in almost all cases be a locally established practitioner, perhaps one of the dis- trict * In rural districts it is probable that tbere would be very few exceptions to the rule that the medical officers of health would be also the Poor Law medical officers.—Second Report, Royal Sanitary Commis- Bion, vol. i, p. 34.