Great Britain. Royal Commission on Poor Laws and Relief of Distress; Poor -- Great Britain; Poor laws -- Great Britain
It may be that it is on the Public Health side, which was in 1871 added
to the Poor Law work of the Central Authority, that we may trace the
influence of the suggestion that was under discussion at the Poor Law
Board under Mr. Goschen's presidency, just prior to its merging in the
Local Government Board. The idea of "free medicine to the poorer classes
generally, as distinguished from actual paupers, and perfect
accessibility to medical advice at all times under thorough
organisation"--which the new permanent secretary, Sir John Lambert, may
have brought back from his official visit to Ireland--finds a certain
expression in the Public Health Act of 1872, re-enacted with additions
in 1875, which created "one local authority for all public health
purposes in every place, so that no area should be without such an
authority, or have more than one." In the rural districts the board of
guardians became this authority. As such they came under a series of
responsibilities based upon ideas diametrically opposed to those of the
Poor Law. Instead of confining their action to actual applicants for
help, they had to search out cases of nuisance or dangerous disease.
Instead of restricting their administration to those who were willing
and anxious for it, they were charged with compelling to be done all
that was required. Instead of being limited in purview to a small class
specially stigmatised as paupers, the guardians had to consider the
whole population as needing their attention without distinction of class
or subjection to stigma. They were expressly authorised, not merely to
repress nuisances, but to provide hospitals "for the use of the
inhabitants," without any limitation to infectious or any other
diseases.[710] They were even empowered, with the consent of the Central
Authority, to "provide or contract with any person to provide a
temporary supply of medicine and medical assistance for the poorer
inhabitants of their district."[711] The Central Authority eagerly
pressed on the local authorities the policy of the new Act.[712] We see
the Poor Law inspectors--who were "in possession of the views of the
(Local Government) Board on the subject"--explaining to boards of
guardians in unions having rural districts their new duties; the future
work of their new Public Health staff of medical officer of health and
sanitary inspectors; and their responsibility for maintaining and
improving the health, not of paupers only, but of the whole
community.[713] We are not here concerned with the progress of public
health administration, in which the boards of guardians cannot be said
to have been apt or willing disciples. It is not to the boards of
guardians, in 1907 still the sanitary authorities in non-urban
districts, that we owe the elaborate medical organisation of an
up-to-date Public Health Department, with its peripatetic health
visitors and diagnosing doctors, its milk depots and campaign against
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