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was not until the Public Health Act of 1871 that every Urban Sanitary Authority
was required to appoint a Medical Officer of Health (the Diploma in Public
Health became a compulsory qualification in 1888) and every Urban and Rural
Sanitary Authority was required to appoint an Inspector of Nuisances. The
designation of the latter was changed to Sanitary Inspector in 1922 and subsequently
to Public Health Inspector in 1956.
The Enfield Local Board of Health made its first appointment of Inspector of
Nuisances at its first meeting on 19th August, 1850, and the Edmonton Local
Board of Health did likewise the following day. Both Boards, however, appear
to have been somewhat tardy in appointing Medical Officers of Health - until
pressure from the Local Government Board resulted in the first appointment to
Enfield on 26th July, 1872, and to Edmonton on 17th March, 1874. Subsequently,
on 22nd June, 1880, a separate appointment of Medical Officer of Health was
made for the Western district of Edmonton, which became established as Southgate
on 29th September, 1881.
During the nineteenth century there was much legislation on environmental health
but little on personal health, and the main responsibilities of the Medical
Officer of Health during that period were therefore mainly concerned with
environmental conditions. One of the statutory duties of the Medical Officer
of Health is still to inform himself respecting all matters affecting the public
health in the district and advising the local authority on any such matter.
The main responsibilities of the Medical Officer of Health at the end of the
nineteenth century were in connection with the control of infectious disease,
including vaccination against smallpox; hospitals for infectious disease; disease
prevention generally; housing, e.g. overcrowding, insanitary dwellings, slum
clearance, common lodging houses, etc; sewerage; water supplies; refuse collection
and disposal; mortuaries and burial grounds; public health nuisances generally;
offensive trades; pure air; certain working conditions and sanitation in factories;
food hygiene and adulteration; and the collection of statistics.
During the early part of the present century many responsibilities, mainly by
personal health legislation, were added to the Medical Officer of Health's
duties. These were concerned with the employment of domiciliary midwives;
notification of births; district nursing service; health visiting service; maternity
and child welfare service and clinics; infant life protection; mental deficiency and
mental illness in the community; immunisation against infectious diseases;
treatment of venereal disease; laboratory service; municipal hospitals and institutions
(probably the first union of preventive and curative medicine under the
Medical Officer of Health except for infectious disease hospitals and treatment
of venereal disease); health centres; ambulance service; and school health service
(in most cases the Medical Officer of Health also became School Medical Officer).
To me it seems that over the years it has been the function of the Medical
Officer of Health to have placed upon him responsibility not only for those