LOCAL GOVERNMENT ACT, 1888. (MEDICAL OFFICERS OF HEALTH.) (Hansard, 17 February 1891)

THE EARL OF DUNRAVEN
, in rising to ask Her Majesty's Government as to the powers and duties of a Medical Officer of Health appointed by a County Council under Section 17 of the Local Government Act, 1888; and to move for a Return of the medical officers appointed, and the Councils appointing them; and also for a Return showing the representations, if any, made to the Local Government Board under Section 19 of the Act, and the results of such representations, said: My Lords, I rise to ask the noble Lord who represents the Local Government Board whether he can give me some definite information as to the powers and duties of Medical Officers of Health appointed by County Councils; and I should be glad if, at the same time, he could also give me some information as to the powers of the County Councils in the matter. We may be preternaturally stupid in requiring any information on the subject, but it appears to me it is very difficult to gather from the Local Government Act what the powers of medical officers appointed by the County Councils are, or what powers the County Councils themselves have. That Act states that the County Councils can appoint Medical Officers of Health, and it is provided that by arrangement with the District Councils their services can be rendered available; and pending the institution of District Councils they could make, I presume, some arrangements with the Urban or Rural Sanitary Authorities. But what those arrangements were, the Act does not specify, and it is impossible to find out. As far as I can gather from the Act, the only action the County Council can take on a Report of a Medical Officer of Health appointed by it would be similar to the action it can take in 814 reference to the report of an ordinary district Medical Officer of Health; that is to say, it can make a representation to the Local Government Board. Of course, any other body or individual can make a representation to the Local Government Board. If an individual does so, the result I fancy generally is that he obtains a large amount of explanation to a minimum of action— the minimum amount of results which can be obtained from the maximum amount of correspondence. I do not mean to challenge the action of the Local Government Board in all cases, because if the Board were to exercise practical supervision over all bodies in all matters which may be brought before it, it would have an amount of work to do which it could not possibly perform. But if that is the only power which the County Councils have in the matter, I do not think they have the power they should possess. The County Councils should have the means of rendering their opinions effective, and it does not appear to me that what the powers of Medical Officers of Health are is at all apparent from the Act. I wish also to move for a Return of the medical officers appointed and the Councils appointing them; and also for a Return showing the representations, if any, made to the Local Government Board under Section 19 of the Act, and the results of such representations. I do not imagine the Return would be very voluminous, and I hope the noble Lord who represents the Local Government Board in this House will have no objection to granting it. If the noble Lord can give me, now, the information I want, I shall be very glad to receive it in that shape, instead of in the form of a Parliamentary Return.

§ EARL STANHOPE
My Lords, this question of my noble Friend's seems to be a very practical one, and I trust that the Government will give the Return that he asks for. As far as I am aware, Section 17 of the Act has never been acted upon, and remains a dead letter. Living in a populous county, the County of Kent, I am able to state what is done there. The Medical Officer of Health is appointed by and for groups of Unions; he reports to those Unions separately, and they take action in the matter if they think fit; but, as far as I am aware 815 neither in Kent nor in any other county has action been taken under Section 17. And, indeed, if action had been so taken, and medical officers had been appointed by each County Council in England, I am very doubtful whether any Report under Section 19 would have any effect whatever, because, as my noble Friend has pointed out, under Section 19 of the Act, only "a representation" can be made to the Local Government Board; but it does not say that any action can be taken by the Council. Being myself a member of the County Council of my county, I am anxious to know how far this clause has been acted upon, and I trust, therefore, that the Motion of the noble Lord for a Return on the subject will be assented to.

§ LORD THRING
I can state that in the case of our County Council, in the County of Surrey, at all events, a Medical Officer of Health has been appointed. I agree that the section requires amendment, and that the powers possessed by the medical officers must be put in proper form, and, as far as necessary, increased.

§ LORD HENNIKER
My Lords, in answer to the question of my noble Friend, asking what has been done under Sections 17 and 19 of the Local Government Act of 1888, it is quite true that under the 17th section of the Act, the County Councils have the power to appoint one or more Medical Officers of Health within their jurisdiction. The Local Government Board are aware that such appointments have been made by some of the County Councils, but there is no obligation whatever on the part of any of the Councils to report to the Local Government Board as to any appointments they make. We have, therefore, no complete list at the offices of the Local Government Board of the cases in which Medical Officers of Health have been appointed. The statute, too, does not in any way prescribe the duties which are to be performed by these officers; nor has the Local Government Board any power whatever to define their duties. In each case the duties must be such as the County Council may choose to lay down when making the appointment. I have no objection to offer on the part of Her Majesty's Government to the Motion of the noble Earl for the Return he asks for of the medical officers appointed, and of the 816 County Councils appointing them under Section 17. Then as regards the question respecting Clause 19, as to representations that have been made to the Local Government Board under this section. Such representations by County Councils have been made from the West Riding of Yorkshire, and by the County Councils of Wiltshire, Surrey, West Suffolk and Durham. These representations have had reference in every case to the sanitary defects which have been specified in reports of the Local Medical Officers of Health. With respect to four of those districts, the Local Government Board have directed an inspection to be made by one of their Medical Inspectors. In other cases, they have been in correspondence with the Sanitary Authorities and with the County Councils. This correspondence is still proceeding in the majority of cases, with regard to the districts concerned. If the noble Earl wishes to move for a Return of these representations, as he suggests, I, on the part of the Local Government Board, will consent to their being granted; but while I give that consent, I must remind the noble Earl what I have said already, that the correspondence upon the subject is still very incomplete.

§ LORD THRING
I would also ask the noble Lord whether the Government are not prepared to amend the section of the Local Government Act of 1888 relating to the duties of County Medical Officers of Health. At the present moment several counties—as I have said before, for example, the County of Surrey—have appointed these medical officers because they think it their duty in the interests of their counties to take a step towards improving the sanitary condition of the districts under their jurisdiction. But it is, I think, the duty of the Government to supply a manifest defect in the powers of the medical officers. No proper powers are conferred upon them. They ought to have jurisdiction given them over various sanitary matters. The extent of that jurisdiction is a question for Her Majesty's Government, and what I desire to ask the noble Lord is whether the Government are or are not prepared to amend the Act of 1888 for the purpose of extending and defining the duties of Medical Officers of Health.

§ LORD HENNIKER
I must ask my noble Friend the noble Lord opposite to 817 give me notice of this question. I can hardly take upon myself to give him an answer to it without notice.

THE EARL OF DUNRAVEN
I should be glad to have the second of the Returns I desired as there is no objection made, because I think the correspondence which has been going on with the Local Government Board has been terminated for some time. I did not quite clearly understand the noble Lord as to whether he could give the Return which I first asked for as to the Medical Officers of Health that have been appointed by the County Councils, and of the County Councils who have appointed them. I understood him in the first instance to say that the Local Government Board had of necessity no cognisance of those appointments. Am I right in understanding that?

§ LORD HENNIKER
Yes.