An Address Delivered in the Section of Public Medicine
Authors: H. W. Acland
Journal: BMJ (1880)

WHEN I had the honour of addressing this Association, as President, at Oxford, in i868, any complete national health organisation was still a thing of the future.Now, " the general working of the Public Health Administration in Great Britain and Ireland" is to be brought before the present meeting as the first subject for discussion.This arrangement makes it unnecessary that I should occupy time with any lengthened remarks from the chair upon the present state of such administra- tion; but, it may assist the objects of the discussion, if I remind the meeting, very briefly, of some of the steps by which the public health administration in this country has reached its present position.This may be best done by referring to a passage in the eighth report of the Local Government Board (I878.CXXViii)."In 1871, the Local Government Board was established, and the powers and duties of the Poor-law Board under the Poor-law Acts, of the Secretary of State under the Registration Acts, the various Sanitary Acts, and the Local Taxation Return Act, and of the Privy Council under the Prevention of Diseases and the Vaccination Acts, were trans- ferred to the new Board thus created; while, in the following year, the powers and duties of the Board of Trade under the Alkali Acts, and the Metropolis Water Acts, and of the Secretary of State under the Highways and Turnpikes Acts, were in like manner transferred to the department." In I872, the whole country was, by an Act passedl at the instance of the then President of the Board, divided into urban and rural sani- tary districts, and each district was placed under the jurisdiction of one sanitary authority, and one only; and provision made for the establish- ment of a port sanitary authority for every port in England and Wales." In i874, we introduced a Bill providing for various amendments in the sanitary laws, which our administrative experience had shown to be imperatively required." In I875, a measure prepared by us was passed for consolidating the whole of the sanitary laws into a single statute, thus reducing into a methodical and complete whole provisions which hitherto had been scattered over no fewer than twenty-two separate Acts of Parliament."In I877, we issued complete sets of model by-laws, relating to almost all the various matters which local authorities are empowered to regulate by by-laws under the provisions of the sanitary law, "Thus it will be seen that, during the last seven years, a single central authority has been established and organised for superintending the administration-of the laws relating to the public health, poor relief, local government, and local taxation." Secondly: that the entire country has been divided into sanitary districts, and a local authority for sanitary purposes established for every district, so that no area is now without such an authority, or has more than one."Thirdly: that the sanitary law has been amended and reduced into methodical form for the guidance of the several sanitary authorities re- ferred to."Fourthly: that they have-been supplied with a code of subsidiary regulations, which, when adopted, will enable them to give full effect to the more general provisions of the law." So far, therefore, as regards the organisation of the central department, the establishment of local sanitary auithorities, the consolidation of the law, and the framing of by-laws, the work may be said to be complete; what now chiefly remains, at least for the present, is to encourage, instruct, and guide the local authorities in the discharge of their responsible duties."