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72
THE MEDICAL OFFICER OF HEALTH
It is now over 100 years since the first Medical Officer of Health
in this country was appointed, and over 75 years since every district was
required to appoint a Medical Officer of Health. For many years, these
were mostly part-time officers selected from those who were in general
medical practice in the locality. They were, of course, more especially
concerned with the problems relating to the environment of those living
in the community. They were especially interested in securing a sufficient
and satisfactory water supply, efficient drainage, sewerage and sewage
disposal, and in securing freedom from nuisances or any other states
that might be injurious to health. They were, above all other interests,
concerned in the control of the spread of infectious diseases and many,
in time, were in charge of the isolation hospitals which were built to admit
the infectious sick. Other legislation passed after the Public Health
Act of 1875 gave them added responsibilities and powers to deal with
such matters as unsatisfactory housing, pollution of rivers, and adulteration
and contamination of food supplies. When the provision of the
personal services which are the development of this century, was added
to the duties of many of the larger local authorities, not only did many of
these find it necessary to appoint their medical officers of health as full-time
servants, but they also found it necessary to appoint additional medical
staff to undertake such duties as the medical inspection of school children
and attendance at infant welfare sessions. In the meantime, County
Councils which had in effect no responsibility of a public health character
until the turn of the century, acquired some by their being the authority
responsible for the administration of certain provisions of the Midwives
Act of 1902 and the Education Act, 1902, not throughout the County,
but only in those parts of the County lying outside of the boundaries of
the larger districts. The very big extension of the maternity and child
welfare services under the Maternity and Child Welfare Act, 1918,
was in effect the limit which the responsibility of the local authorities—as
opposed to the County Councils—for the personal services reached,
because almost all new services went to the County Councils and
County Borough Councils. Apart from County Boroughs, then, in
all districts there were services provided, some by the County District
Councils, some by the County Councils. In the meantime, the same
arrangement of appointment continued, in most of the smaller
County Districts, the Medical Officer of Health for the district being only
a part-time officer of the authority. In the 1920's the practice grew of
the making of combined appointments, the officer engaged whole-time
in the public health service being for part of his time, Medical Officer
of Health of the district, and for the remainder an Assistant County
Medical Officer. This practice was markedly extended by arrangements
made under Section 58 of the Local Government Act, 1929, by which
" The Council of every County Council shall after consultation with the
Councils of districts wholly or partly within the County formulate arrangements
for securing whether by a combination of districts or otherwise
that every Medical Officer of Health subsequently appointed for a district
shall be restricted by the terms of his employment from engaging in