HC Deb 01 November 1909 vol 12 cc1607-19

Lords Amendment: Leave out Subsection (2) The Local Government Board may by order prescribe the duties of medical officers of health appointed by a county council under Section seventeen of the Local Government Act, 1888, whether before or after the passing of this Act.


We agree, but desire to insert a new Sub-section.

Question, "That this House doth agree with the Lords in the said Amendment," put, and agreed to."


The new Sub-section which I have to move is as follows:—

"The duties of the medical officer for the county shall be such general duties as shall be prescribed by the Local Government Board, and such other duties as may be assigned to him by the county council."

I move this Amendment because it is generally felt that this Housing and Town Planning Bill makes it obligatory on the local authority to appoint a medical officer of health to devote his whole time to his duties, and that being so, it is deemed right that the Local Government Board shall be the power to do what it does in regard to some other officers, and that is to prescribe his duties. We do not prevent the county councils themselves from prescribing duties which are to devolve upon the medical officer. We feel it is our duty to see that the medical officer of health shall not be dismissed by the local authority without just cause. I sincerely trust that the House will support me in inserting this provision.


These words are very far reaching in their effect, and I submit that they are entirely unnecessary. If instead of this new Sub-section the Government were content to say that in the discharge of these duties the county council should act through and with the medical officer, that I think would meet the case. My right hon. Friend must be aware that there are other Acts of Parliament under which the medical officers of health have important work to do—such, for example, as the Rivers Pollution Act, etc., and it is perfectly obvious that the method followed for many years in many counties by which the county councils carry out statutory duties, with the help of the medical officer, has worked extremely well. The county medical officers have no contribution made to their salaries by the Local Government Board or any central department. I submit that this provision will not be helpful to the local government in any way, that it will be slighting the county councils, and it will be embarrassing to the officials if their duties are to be dictated by one authority in London and supervised by another authority, say, in Cumberland. Surely a proper course is that the duties of the local authority should be specified by Act of Parliament, and that those duties should be carried out by it with the help of the medical officer. The medical officer should give the whole of his time to his duties, I agree. But we do say it is a positive hindrance to the smooth administration of local self-government to have the duties of an officer prescribed by a Government Department and not by the actual employés of these most important officials. Besides, under the words proposed to be inserted by my right hon. Friend it would be quite open for the Local Government Board to alter the officer's duties from time to time, or to modify them just as they chose, and the people who have to arrange for his salary would be seriously embarrassed. I say nothing now in regard to provisions by which county councils of over 20 years standing which have appointed and dismissed medical officers of health, have only now to dismiss by permission of the Local Government Board. On this Amendment I would only impress on the Government for the sake of the smooth working of the Act not to tie down these officers in this way.


I should like to join with the hon. Member in his appeal, and I regret that the right hon. Gentleman should have felt it necessary to insert this Sub-section. I fully agree with the desire to see reasonable security given to medical officers of health, and as one acquainted with the duties and education of medical officers of health, I rejoice to see that this Bill gives them greater security of tenure, and does not allow them to be appointed for a limited period. At the same time I regret this invasion on the rights of the local governing bodies. I think "such general duties" of the medical officers are so well known that they need not be prescribed from Whitehall. I hope the right hon. Gentleman will be content with the other great provisions of the Bill and not press for this alternative Amendment.


The campaign against bad housing ought to be directed on general principles, and these should be laid down by the Local Government Board in order that there may be the necessary uniformity of action and common scientific principles in conducting work so closely allied to public health. The local control of the medical officer under this Amendment will still be retained by the county

council. In this matter of public health we do not owe any great debt of gratitude to the county councils. For many years most of them neglected their duties in this respect. Only a few of them seriously undertook these duties. When the Bill of 1888 was before the House I contended for the compulsory discharge of duties in this connection, and it was not granted. The right hon. Gentleman is even now obliged to put in a Clause in the Bill compelling the county councils to do their obvious duty and appoint a medical officer of health. I think no county council will be injured by having general regulations laid down by the highest possible authority in this country—I might say by the highest authority in these matters in the world. Surely no county council can arrogate to itself the same authority and the same scientific knowledge as the great health department of London, which is the envy of Continental nations. Other nations all admit that the Local Government Board Health Department is an excellent institution. And now to-night we are asked by an obscurantist opposition to object to this body laying down general rules for conducting the campaign of public health in the country. I hope the House will support the Amendment.

2.0 A.M.


I am not so much concerned as regards the general rule proposed in the Amendment, but there is one item in the Amendment which I think the House would do well to consider before it supports this giving of a right of appeal by a medical officer to the Local Government Board.


That does not arise on this Amendment.

Question put, "That those words be there inserted in the Bill."

The House divided: Ayes, 77; Noes, 25.

Division No. 888.] AYES. [2.5 a.m.
Acland, Francis Dyke Cotton, Sir H. J. S. Henry, Charles S.
Ainsworth, John Stirling Davies, Sir W. Howell (Bristol, S.) Herbert, Col. Sir Ivor (Mon., S.)
Allen, Charles P. (Stroud) Dewar, Arthur (Edinburgh, S.) Higham, John Sharp
Balfour, Robert (Lanark) Duncan, C. (Barrow-in-Furness) Hobart, Sir Robert
Beale, W. P. Dunn, A. Edward (Camborne) Horniman, Emslie John
Bowerman, C. W. Essex, R. W. Howard, Hon. Geoffrey
Brooke, Stopford Evans, Sir S. T. Hudson, Walter
Brunner, J. F. L, (Lancs., Leigh) Foster, Rt. Hon. Sir Walter Jones, Leif (Appleby)
Bryce, J. Annan Fuller, John Michael F. Jones, William (Carnarvonshire).
Burns, Rt. Hon. John Glover, Thomas Jowett, F. W.
Byles, William Pollard Goddard, Sir Daniel Ford King, Alfred John (Knutsford)
Causton, Rt. Hon. Richard Knight Harcourt, Rt. Hon. L. (Rossendale) Lamont, Norman
Cherry, Rt. Hon. R. R. Harcourt, Robert V. (Montrose) Lehmann, R. C.
Clough, William Hedges, A. Paget Lewis, John Herbert
Corbett, C. H. (Sussex, E. Grinstead) Henderson, Arthur (Durham) MacVeagh, Jeremiah (Down, S.)
Maddison, Frederick Pickersgill, Edward Hare Tennant, H. J. (Berwickshire)
Markham, Arthur Basil Pointer, J. Toulmin, George
Marnham, F. J. Price, Sir Robert J. (Norfolk, E.) Ure, Rt. Hon. Alexander
Masterman, C. F. G. Radford, G. H. Walsh, Stephen
Micklem, Nathaniel Raphael, Herbert H. Walters, John Tudor
Middlebrook, William Roberts, Charles H. (Lincoln) Ward, W. Dudley (Southampton)
Mond, A. Roberts, Sir J. H. (Denbighshire) White, Sir Luke (York, E. R.)
Morrell, Philip Rogers, F. E. Newman Williams, J. (Glamorgan)
Murray, Capt. Hon. A. C. (Kincard.) Samuel, S. M. (Whitechapel)
Newnes, F. (Notts, Bassetlaw) Seely, Colonel TELLERS FOR THE AYES.—Mr. Joseph Pease and Captain Norton.
Parker, James (Halifax) Summerbell, T.
Pearce, Robert (Staffs, Leek) Taylor, John W. (Durham)
Balcarres, Lord Ferguson, R. C. Munro Stanier, Seville
Bignold, Sir Arthur Forster, Henry William Talbot, Lord E. (Chichester)
Bowles, G. Stewart Hay, Hon. Claude George Valentia, Viscount
Cave, George Kerry, Earl of Whitbread, S. Howard
Cecil Evelyn (Aston Manor) Lyttelton, Rt. Hon. Alfred Wortley, Rt. Hon. C. B. Stuart-
Cheetham, John Frederick Morpeth, Viscount
Clyde, J. Avon Newdegate, F. A. TELLERS FOR THE NOES.—Mr. Adkins and Sir W. Collins.
Dickson, Rt. Hon. C. Scott O'Brien, Patrick (Kilkenny)
Couglas, Rt Hon. A. Akers- Pirie, Duncan V.

Sub-section (5).—A medical officer of health of a county shall be removable by the county council with the consent of the Local Government Board and not otherwise.

Lords Amendment: Leave out Subsection (5).


I move "That this House doth disagree with the Lords in the said Amendment."


There are reasons why I hope the House will agree with the Lords in this particular Amendment. Of all clauses in the Bill the one which proposes that county councils shall no longer dismiss their servants is one which has the least possible authority behind it. It did not appear in the Bill in the first instance. It was added upstairs as part of the somewhat intricate parleyings between the right hon. Gentleman and the hon. Member for Chippenham (Sir J. Dickson-Poynder), in which, if I remember rightly, the hon. Member did not get the best of it. When it came down here upon the Report stage it was not discussed because of the operation of the guillotine. I hope that the right hon. Gentleman and the Government will realize that the universal objection to this on the part of the county councils does not proceed from any wish whatever to treat their medical officers badly, but on the ground that many of them have had their medical officers for many years. More than 25 have them at present. During the whole of the 21 years since county councils were first created by Statute there has never been one complaint made as to the way in which they have treated their medical officers, nor any suggestion whatever that they have dismissed medical officers because they were doing their duty too well or for any improper reason whatever. I certainly ask the House to give its support to an Amendment which merely retains to a popularly elected local authority the power given to it by Parliament 21 years ago, which has never been abused. It is surely no part of the case for the Bill to take away from a representative local authority the power which has never been misused in the whole of its career.

We are all familiar with the arguments which have been used and the cases stated with regard to the very small local authorities, who no doubt have been open to criticism upon this point. But because some small district council has not always treated its medical officer in the proper way should county councils, who have always treated them properly, now have this humiliation put upon them. My first point is that it is not in accordance with local self-government to take away a power which has been used properly, which has led to no form of evil whatever, and in regard to which no complaint has ever been made. I hope hon. Members will bear with me. I am not speaking now on party lines, but from the point of view of good local government. If you strike out the Amendment and leave medical officers in such a position that they cannot be dismissed without the leave of the Local Government Board, are you making for good administration? I say you are not. If the Local Government Board demur and say you are not to dismiss your medical officer, and if the county, which is a large community with an important area, wish, rightly or wrongly, their official to go, do you imagine there can be sound adminis- tration with a state of friction like that existing? Even my right hon. Friend, with his somewhat inflated notion of what the Local Government Board can do, has never gone so far as to fix the salaries of the county medical officers of health, and if the county councils have the power of the purse and the Local Government Board has merely the power of preventing an official being dismissed, you will have created that system of dual control which never works well in administration. Either a local authority is intelligent enough and honest enough to be trusted or it is not. If it is intelligent and honest enough to be trusted there is no need for this new fettering of its functions. The whole experience of twenty years is against there being any such fettering.


My hon. Friend forgets that this Bill places entirely new duties on the medical officers of health, and that they are to have relations with property owners which they never bad before to the same extent. One of the matters with which I frequently had to deal when at the Local Government Board was the dismissal of district medical officers because they had interfered with bad property, and we had a difficulty in keeping these men in their positions. I should like to see, not only every county medical officer of health, but every officer of health in the country have the right of appeal to the Local Government Board. It would protect and encourage them in the discharge of duties which are always difficult and delicate. No local authority will ever be refused by the Local Government Board the right of dismissal when officers have done wrong. It is only when the medical officer is in the right that the Local Government Board will not sanction his dismissal.


No doubt the case for the Local Government Board has been very well put by my right hon. Friend who has just spoken. But there is another side to the question, and the hon. Member for the Middleton Division of Lancashire (Mr. Adkins) put his point extremely well. If you have dual control it is impossible for you to get rid of a public servant however incompetent he may have become. If you had a Local Government Board intervening it means that there is an inquiry, and I cannot conceive anything less conducive to efficiency in the public service than that when there is a good case for the dismissal of one of the public officials there should be a long, drawn-out inquiry, and then either the refusal or the agreement of the central authority in regard to the dismissal. The fact of the matter is that the local authorities are, as a rule, somewhat easygoing in selecting their officials—i.e., in many cases; but they are far more easygoing when it comes to getting rid of an official who is notoriously incompetent. You do allow a fixity of tenure with medical officers in this Bill. I am certain that dividing the responsibility does weaken the efficiency of the public service, and on that ground I do not think this is a case where the central authority should be called in.

Viscount MORPETH

The right hon. Gentleman, the Member for the Ilkeston Division, told us that when he was at the Local Government Board he was constantly occupied in guarding against corrupt dismissals of medical officers by the local councils.


I must ask the Noble Lord not to put into my mouth a statement I did not make. I said I had such cases frequently before me when I was at the Local Government Board.

Viscount MORPETH

Well, frequently. That is, I think, a synonymous term for "constantly," which I think I used. The right hon. Gentleman certainly gave the impression that he was largely occupied in protecting medical officers against corrupt dismissals by local authorities. I say that these local authorities which cannot be trusted to treat their own servants properly should never be entrusted with the enormous amount of complicated work which they have so long undertaken. If our local Government system is so corrupt as to unfit the councils for control in this matter it is certainly very undesirable that the powers under this Bill should be put into their hands. And when the right hon. Gentleman brings these charges as lightly as he has done, it seems to me that it is not altogether public spirit, but a medical trades unionism which has induced him to take the view he has expressed. We are told that it is perfectly easy to get incompetent officials dismissed, and that the Local Government Board would never stand in the way of such a dismissal. If any Member of the House will take up one of the reports—I do not recollect whether the majority or the minority report—of the Poor Law Commission, which has just been issued, he will see that one of the difficulties in poor law administration was when there was inefficiency in the poor law administration the guardians were hampered in their work and had to obtain the help of the Local Government Board to dismiss any incompetent servants. Local authorities, so far from dismissing too readily, are apt to tolerate too long inefficient and incompetent officials. An official might be incompetent, but it might be very difficult to substantiate charges before a local enquiry.

I maintain that if the local authorities cannot be entrusted with this work, and if the members are not fit persons to judge of the competence or otherwise of the persons employed, it would be far better to take the work out of their hands, and I daresay that the right hon. Gentleman the Member for the Ilkeston Division (Sir W. Foster) would view with some pleasure the taking of local government out of the hands of the people and the placing of it in the hands of members of the medical profession. The real fact is that doctors, like some others, need keeping in order. It will be a very dangerous thing when we hand over the government of the country to experts. I hope the House will not think I am an enemy of the medical officers. In the local work I have had to do in the country my endeavour has been to get medical officers appointed. It is only because I think the course the Government are taking is mischievous that I take up this attitude. It is impossible to have a system under which a servant of the local authority is paid by one person, while he is really governed by another. After all, the persons who have the right to discharge an official are the persons who have control over him. This is an extraordinary and important matter. The Government have chosen to deal with these Lords Amendments to the Housing and Town Planning Bill in a single day; but because the Government have adopted that course, that is no reason why we should not discuss these matters. I have no desire to obstruct, and I am not obstructing. I can assure the right hon. Gentleman that all the local authorities of the country feel very strongly about this matter, and I can assure the right hon. Gentleman that he is adopting a dangerous course when he tries to override the local authorities.


There is really very little to be said in support of the action of the Government in this matter. Everything that could have been said has been admir- ably said by the right hon. Gentleman for the Ilkeston division (Sir W. Foster), and to that statement of his no reply has been made. In the event of there being an incompetent medical officer in the service of a local authority the Local Government Board will support the local authority to get rid of him. We believe that the interests of the local authorities can best be served by the course we are suggesting, viz., that a medical officer shall not be dismissed without the sanction of the Local Government Board. That enables us to stand by a public spirited and competent medical officer who is honestly striving to carry out his duties against, perhaps, a great interest.


The right hon. Gentleman has told us that the course the Government are adopting will enable the Local Government Board to stand by a public spirited and competent officer against the local authority. Has the right hon. Gentleman considered who is going to pay the salary of the officer if the local authority does not want him? Are the local authority to be forced to pay him?


No. If they do not want him, let them dismiss him.


No. That is not the point. The right hon. Gentleman said the Local Government Board would stand by him.


No; not if he is not fully competent.


It will enable the medical officer to stand up against what the right hon. Gentleman calls a great interest. If he makes himself unpopular and the local authority desire to dismiss him, the right hon. Gentleman says it is important that the local authority should not be able to do so without the consent of the Local Government Board, because it might be necessary for the Board to stand by him. Another point is that the local authority may desire the dismissal of a medical officer, and the right hon. Gentleman may wish to refuse that course. I ask in these circumstances what would be the position of a medical officer? He would have to go on acting as the medical officer of an authority which does not want him, and which wants to dismiss him. Does the right hon. Gentleman propose in that case to force the local authority to pay the salary of a man as their officer whom they do not want and whose only desire is to dismiss him at the earliest opportunity I That kind of thing cannot make for good local administration.


I think we should turn our minds away from the big Lancashire councils to the rural districts. There you have a body of gentlemen meeting in the county councils, the majority of whom are landlords. Let a medical officer under such a council set about attacking the cottage accommodation that is owned by one of those gentlemen and what is his job worth? How long is he going to be happy in it? You want to stiffen these men and knowing something about rural districts I am bound to say that if you propose—as the Noble Lord (Viscount Morpeth) and those who support him do propose—to continue the present state of things, you will keep up as houses fit for human beings things which are not fit for stables. The right hon. Gentleman has given away quite enough over this Bill. I hope he has got his back up and will stick to this.


County councils are the most popularly elected bodies in any country, and I hope the House of Commons will respect these popularly elected bodies.


How many labourers have you on yours?


The County Councils Association have unanimously asked that the Amendment made by the Lords shall be supported by us. As an old member of a county council in a rural district I feel

confident that county councils will do the duty which Parliament commits to them honestly. Inasmuch as they have to pay the officers they ought to have the right to dismiss them. That they will deal fairly and honestly with their officers I am quite sure. I am in favour of the Amendment.


I could not sit through this discussion without stating that in my experience the practice of allowing an appeal to a central authority has worked out badly in many instances. It is not always that a local authority is quite sure that they would be able to sustain an appeal. They must feel perfectly convinced that it is their duty to dispense with an officer, but they are faced with the situation that if the Local Government Board takes a different view and upholds the appeal the position would be intolerable. There may be certain small local authorities where certain interests have become more fully represented than they ought to be and the case has been made awkward for an official. But there is the other side. Supposing a county council is anxious to go ahead and do their work thoroughly, and they are dissatisfied with the inaction of the medical officer. If they were to appeal to the Local Government Board I should not be sure that the Local Government Board would uphold them in their decision.

Question put, "That this House doth disagree with the Lords in the said Amendment."

The House divided: Ayes, 75; Noes, 23.

Division No. 889.] AYES. [2.37 a.m.
Acland, Francis Dyke Harcourt, Rt. Hon. L. (Rossendale) O'Brien, Patrick (Kilkenny)
Ainsworth, John Stirling Harcourt, Robert V. (Montrose) Parker, James (Halifax)
Allen, Charles P. (Stroud) Hedges, A. Paget Pearce, Robert (Staffs, Leek)
Balfour, Robert (Lanark) Henderson, Arthur (Durham) Pickersgill, Edward Hare
Beale, W. P. Henry, Charles S. Pointer, J.
Bowerman, C. W. Herbert, Col. Sir Ivor (Mon. S.) Price, Sir Robert J. (Norfolk, E.)
Brooke, Stopford Higham, John Sharp Radford, G. H.
Brunner, J. F. L. (Lancs., Leigh) Hobart, Sir Robert Raphael, Herbert H.
Bryce, J. Annan Horniman, Emslie John Roberts, Charles H. (Lincoln)
Burns, Rt. Hon. John Howard, Hon. Geoffrey Rogers, F. E. Newman
Byles, William Pollard Hudson, Walter Samuel, S. M. (Whitechapel)
Causton, Rt. Hon. Richard Knight Jones, Leif (Appleby) Seely, Colonel
Cherry, Rt. Hon. R. R. Jones, William (Carnarvonshire) Summerbell, T.
Clough, William Lamont, Norman Taylor, John W. (Durham)
Corbett, C. H. (Sussex, E. Grinstead) Lehmann, R. C. Tennant, H. J. (Berwickshire)
Davies, Sir W. Howell (Bristol, S.) Lewis, John Herbert Toulmin, George
Dewar, Arthur (Edinburgh, S.) MacVeagh, Jeremiah (Down, S.) Ure, Rt. Hon. Alexander
Duncan, C. (Barrow-in-Furness) Maddison, Frederick Walsh, Stephen
Dunn, A. Edward (Camborne) Markham, Arthur Basil Walters, John Tudor
Essex, R. W. Marnham, F. J. Ward, W. Dudley (Southampton)
Evans, Sir S. T. Masterman, C. F. G. White, Sir Luke (York, E. R.)
Foster, Rt. Hon. Sir Walter Micklem, Nathaniel Williams, J. (Glamorgan)
Fuller, John Michael F. Middlebrook, William
Glover, Thomas Mond, A. TELLERS FOR THE AYES.—Mr. Joseph Pease and Captain Norton.
Goddard, Sir Daniel Ford Morrell, Philip
Gooch, George Peabody (Bath) Murray, Capt. Hon. A. C. (Kincard.)
Balcarres, Lord Ferguson, R. C. Munro Stanier, Beville
Bignold, Sir Arthur Forster, Henry William Talbot, Lord E. (Chichester)
Bowles, G. Stewart Hay, Hon. Claude George Valentia, Viscount
Cecil, Evelyn (Aston Manor) Jowett, F. W. Whitbread, S. Howard
Cheetham, John Frederick Kerry, Earl of Wilkie, Alexander
Clyde, J. Avon Lyttelton, Rt. Hon. Alfred Wortley, Rt. Hon. C. B. Stuart-
Cotton, Sir H. J. S. Morpeth, Viscount
Dickson, Rt. Hon. C. Scott Newdegate, F. A. TELLERS FOR THE NOES.—Mr. Alfred King and Mr. Everett.
Douglas, Rt. Hon. A. Akers Pirie, Duncan V.

Bill read the second time, and committed to a Committee of the whole House.

Sub-section (7).—A medical officer of health appointed under the said Section as Amended by this Section shall not engage in private practice and shall not hold any other public appointment without the express written consent of the Local Government Board.

Lords Amendment: After "appointed" ["appointed under the said Section"] insert "after the passing of this Act."


I move "That this House doth agree with the Lords in the said Amendment."


I am rather sorry to hear my right hon. Friend agree with this Amendment. It is a very bad system that any medical officer should be allowed to engage in private practice. There should be a universal system to the contrary.


The Sub-section could only apply to officers appointed after the passing of this Bill.