1873-77 Heber Dowling Ellis
1877-80 Herbert Alfred Lawton
1880-86 Frederick Edwin Vernede
186-1903 Herbert Alfred Lawton
1903-13 George Hedwig Carrington
1914-15 Austin Threlfall Nankivell
1915-18 William Gosse (Acting)
1918-21 Austin Threlfall Nankivell
1921-42 Robert Maule Horne
1942-52 George Chesney
1952-74 James Hutton
For 101 years the Medical Officer of Health for Poole was responsible for improving the public health of the town. These were the people who brought Poole forward from the Victorian days of filthy and smelly streets and alleys, slum housing, frequent epidemics, overflowing cesspits, high infant mortality, no maternity services, no health promotion, no public immunisation campaigns, no isolation hospitals.
Just 8 men held the post in 101 years, plus one as Acting Medical Officer of Health during the war service of Dr Nankivell. No women – although there was a period of some weeks when the postholder was off sick and his doctor wife stood in for him.
The first ones were part-time, working mainly as GPs. Their time as Medical Officer of Health (MoH) would not have been a prestigious appointment – working for the Council afforded much less social prestige than meeting the medical needs of the town’s better-off citizens. Eventually it became a career post, a head of department in local government with a large staff of qualified people in specialised positions.
The post was created by the 1872 Public Health Act, which decreed that municipal boroughs had to appoint both an MoH and an inspector of nuisances. In rural districts the responsibility was placed on the Board of Guardians to appoint an MoH. The profession of public health doctor was thus created. The MoH did not have to be a full-time appointment and In common with most councils, Poole’s first MoHs continued working as GPs. The Local Government Board, forerunner to a Ministry of Health, had offered to subsidise half the salary but with the proviso it had a say in what the MoH actually did. Poole refused this offer, thereby keeping control of the work and, importantly, the expenditure. The council’s expectations about the post were certainly low – in 1873 it laid down that the first MoH need only confer with the Council “from time to time.” No specific qualifications were required beyond being medically qualified, although later the Diploma in Public Health was necessary. Poole initially offered a salary of £60 pa on a 3 year contract. Most appointments at the time had similar time-limited contracts, but £60 was probably above the average paid.
In the earlier years the management of public health was in the hands of Urban and Rural Sanitary Authorities. But for Poole this meant merely that the Council was the Sanitary Authority, operating with a separate Sanitary Committee. This committee thus dealt with all the environmental issues that were previously discussed in the full council meetings. Strangely the Fire Brigade was included in the coverage.
The MoH’s patient was not the person but the whole community. The precise duties laid down in detail by the Local Government Board in 1872 numbered 18 separate tasks. These together required the postholder to inspect and report on the local public health, look into the occurrence of epidemic diseases such as cholera and typhoid, and to advise the council on how to deal with them. An annual report was to be produced for the council and the Board, and made public. The Public Health Act of 1875 then set the agenda for the sanitary code to be followed. Sanitary is not a word much used in that context today, but then it meant the supply and quality of water, dealing with drains and sewerage and nuisances, food inspection, street cleaning, housing inspections, and regulation of markets and slaughterhouses. These were all matters of great relevance to Poole’s public health, but in many ways were also contentious issues in that they led the MoH into disputes with many local residents and businessmen – landlords, shopkeepers, publicans, factory owners and others. These were influential people, often councillors. The MoH across the country was at risk of removal from office if he upset too many of the wrong people – security of tenure in his post was always a matter of concern. This situation led to one of Poole’s early MoHs not having his contract renewed, being accused by some of having done the job “too well”. Scrutiny by the Local Government Board also had its perils – on several occasions inspectors were sent from London to review how well they performed.
But in dealing with infectious diseases the MoH was at least seen as an expert voice. Poole was no stranger to epidemics and as a port was always at risk of disease being imported into the town. The creation of hospitals to cope with infectious disease was quickly seen as the most important step an MoH could take. In 1872 Poole had no hospital of any kind. The first postholder, Dr Ellis, was able to deal with that, after some false starts, and the isolation hospital at Baiter resulted. Later Alderney Isolation Hospital was added to his responsibilities, having been set up by the Rural Sanitary Authority for Kinson. It was only in relation to the isolation hospitals that the MoH kept direct clinical contact with individual patients.
The extra responsibility that port towns faced was recognised in the creation of Port Sanitary Authorities, with their own MoH. Poole was offered by the Local Government Board the opportunity to be the Sanitary Authority for Poole harbour, which it accepted. Poole’s MoH was then given the extra responsibility for all port health matters, with a small salary of its own to add to his total earnings. But these were still separate posts, with separate contracts. In fact, as well as being MoH and port MoH, the postholder was also employed as School Medical Officer for the borough – 3 jobs in one, each with a separate salary.
Over time, the duties changed and the MoH post developed, requiring more staff and evolving into a big department of the council. Those staff eventually included such as laboratory staff, veterinary inspectors, community dentists, health visitors and midwives. School health became a major responsibility, and occupied a large part of the annual report. The list of MoHs above are those doctors appointed by the Borough of Poole, but there were other MoHs with responsibilities in what is now Poole. Branksome Urban District Council had its own MoH during its short existence at the turn of the twentieth century, having itself absorbed part of Kinson Urban Sanitary Authority. Poole Rural Sanitary Authority was responsible for those areas covered by the Poole Board of Guardians outside the town itself, including Canford Magna and the Lytchetts. The medical officer for the workhouse was the first MoH, but as time went on, there were medical officers for different parts of the area, with an MoH in overall charge for the rural districts. One of these, William Gardner Robinson, held the post for nearly 30 years.
In 1974 there was a reorganisation of both local government and the NHS, with a split between personal health and environmental health. The MoH was replaced by the community physician, who was employed in the NHS and not local government. Meanwhile Poole Council now had an Environmental Health Department, which included a responsibility for port health matters. More recently further changes have seen public health return to local government, with Directors of Public Health as successors to MoHs.
The individual doctors who served as MoH, whether the early GP part-timers or the later career public health specialists, played a huge part in improving the health of Poole for its residents. Their annual reports in themselves serve as detailed histories of Poole’s health record since 1873, with valuable epidemiological statistics. The personal biographies of each MoH, and the events of their time in office, are worthy of recording – from the light-hearted warning of the health perils of spring cleaning to the sad story of the one struck off; from the member of the Dutch aristocratic family to the proud Scot who was Chieftain of the Dorset Caledonian Society; from the expert on diphtheria immunisation to the one on oyster fisheries. It is planned to tell all their stories in future posts.