1867.] The Public Health, 455 



their members and the extension of areas of local government, so as 

 to provide for an economical and efficient administration of the health 

 laws. He showed how this extension of area affected the appoint- 

 ment of health officers, and urged the necessity for an entirely- 

 different system of those appointments which in the provinces were 

 made under the Public Health Acts. He instanced the inspection 

 of factories and work places, especially the extension of the Factory 

 Acts now before the House of Commons as a reason for appointing 

 a highly qualified class of officers rendered independent of private 

 practice and debarred from it. He noticed the importance of such 

 independence as regards certificates of health, age, and fitness for 

 labour of the children employed. He also mentioned Mr. Torrens's 

 Bill for dwellings for the labouring classes as requiring the action 

 of a health officer, who ought certainly to be independent of the 

 proprietors and householders of the wretched hovels he might have 

 to condemn. The basis of an improved organization, he considered, 

 was to be found in the registration divisions of the country which 

 are identical with the poor-law unions. It is in these districts that 

 the great facts of disease and mortality are recorded ; in these, there- 

 fore, a scientific officer is especially needed, both to correct and 

 verify those returns, and to apply them to the suggestion of practical 

 remedies. It would be a most false step in sanitary legislation to 

 compel every small local board to appoint its own officer of health 

 on its own terms. He warned the Government against enforcing, 

 or even encouraging the present defective system of these appoint- 

 ments, and urged the importance of making a new organization of 

 scientific persons the foundation of a truer sanitary reform. 



Dr. A. P. Stewart drew attention to the want of Health Officers 

 throughout the country. In London alone was the appointment of 

 officers of health imperative, and he showed that the size and popu- 

 lation of their districts varied enormously, as also their salaries, one 

 having as little as twelve guineas, another as much as 1,000Z. a 

 year. Only in nineteen out of fifty-nine large districts were health 

 officers appointed, and the average of inspection was in London one to 

 34,000, and in provincial towns one to 42,000, of a population, 

 rendering impossible any effectual inspection or removal of nuisances. 

 And, as if to complicate matters still more and to prevent any 

 hearty co-operation in carrying out sanitary improvements, the 

 inspectors of nuisances were in not a few instances independent of 

 the officer of health, under whose control they should always be 

 placed. 



These remarks afford a lesson, and hit a blot in our sanitary 

 legislation. The Metropolitan Management Act made it compulsory 

 on the vestries to appoint medical officers of health. The conse- 

 quence has been that London has got its medical officers of health, 

 and in districts where the vestries are not wholly abandoned to the 



