The decision to appoint Herbert Lawton as the Medical Officer of Health for Poole in November 1877 seems quite odd. He was just 26 years of age, younger than of all of Poole’s other Medical Officers. It was a remarkably young age to be responsible for the many public health issues facing the town. Though he had been a full partner in a medical practice for 2 years, he had now become the clinical manager and advisor to Poole Council on all public health matters. And as well as being so young, he had no previous experience in public health!
He was just the second holder of the post. Poole’s very first Medical Officer of Health, Heber Dowling Ellis, had resigned suddenly, after 4 years in post. His unexplained resignation came only months after accepting a second term as Medical Officer of Health (MoH), and he promptly moved away from Poole altogether. Again, odd!
There was obviously now an unexpected problem for Poole Council. Ellis had had a high profile in the town, being a councillor, magistrate and Sheriff of Poole before his appointment as MoH. He had set up Poole’s first hospital, a major step forward for the health of the town. And yet the council’s response to their problem was to appoint an inexperienced doctor who had been in Poole for just a couple of years.Unlike Ellis, however, Herbert made Poole his permanent home.
Herbert Alfred Lawton had been born in London on 9th July 1851, son of Dr Richard Lawton and his wife Elizabeth (nee Josselyn), who were originally from Suffolk. Richard was a member of the Cobbold family, well known in Ipswich for their brewery business. However Herbert’s destiny was to follow his father into medicine rather than the brewing trade. By May 1867, aged 16, he was indentured as an apothecary apprentice, prior to studying medicine. The 1871 census shows him as a medical student living in York Road, Lambeth, whilst studying at St Thomas’ Hospital. His first post was as a junior house surgeon at Westminster Hospital, prior to moving to a similar post far away at the Royal Liverpool Infirmary. However he then made the long move to Poole. It is not known what drew him so far, for there seem no previous links with Poole or the South Coast.
So far, the first record traced of his presence in Poole is for March 1875, when he appears in a list of members of the Amity Lodge of Freemasons. He is then noted as a partner in the medical practice of Philpotts, Philpotts and Lawton. The 1881 census shows a Dr Philpotts as his neighbour in the High Street. Herbert was living at 5 High Street, now with a family. He had probably met wife Nessie, née Brown, when in Liverpool, and they married on 12th February 1878 in Cheshire. Their first child, Harold, was born in January the following year, the first of 5 children.
Once in the town, Herbert must have set himself to be a person of note in Poole. As was then the norm for medical men, he took on a number of paid positions alongside his medical practice. These included being a medical officer to the local railway company, a medical officer and public vaccinator with the Poole Union, which ran the workhouse and poor relief outside its walls, and as medical officer to the Lytchett District. Also he joined several freemason lodges around the area, which no doubt helped to cement his professional practice in the community. So it was perhaps no surprise that he should apply for yet another post, the Medical Officer of Health, when Ellis suddenly resigned.
On 6th November 1877, the Town Council appointed Herbert for the dual role of Medical Officer of Health for the town and the port of Poole. Councillors voted 11 to 6 in his favour, against a rival doctor, a Mr Turner. The newspaper reports do not suggest any great depth of consideration in the appointment, although the reporter may not have been entirely fair in selecting quotes. At just 26 years of age, Herbert was now in post, with probably no experience in public health to fall back on. And really not much experience in medicine generally.
He must have been a confident man. Possibly over-confident, in not being fully aware of the political aspects of this new role, which was soon to affect him. However, he now had a salary of £60pa, plus another £5 pa as the port MoH.
A worrying start
Although not involved in local politics himself, Herbert immediately ran into a problem concerning the council because of his medical partnership with Edward Philpotts, who had a high profile in the town. A writ was issued against Dr Philpotts, on the basis that he was now in a partnership with a paid employee of the council, which was forbidden for council members. The writ was issued by Philip Budge, a prominent solicitor, and was one of several issued against councillors, following previous cases which he had brought challenging local elections. The case against Dr Philpotts was very specifically in relation to his partner’s new post, and seems to have been successful. The Local Government Board did write to Herbert, saying there was no question that he was disqualified to be M0H. But Philpotts was certainly adversely affected, which was a matter of some stress to all. Their medical partnership was dissolved the next year!
Poole Council itself faced a problem arising from the appointment of Herbert, though whether its members realised beforehand is unclear. The Council had previously tried to keep full control of their MoH’s work. When Ellis had been appointed as the first MoH, the council was fearful of being beholden to officials in London for their record on public health. It had resolved not to accept any funding from the Local Government Board in London for the MoH post. This was quite an aggressively defensive stance! However the 1875 Public Health Act had changed the situation and the Board now had to be consulted on new appointments. Herbert Lawton had actually already had a contract with the Board, because of his role as a paid medical officer to the Poole Union. The council now had no choice but to accept funding towards the costs of the post and its work. Henceforth the Board was in a position to influence local public health decisions and had to be sent annual reports on the state of the public health in Poole. This must have caused some unease amongst council members. They foresaw expense!
So the appointment of the young Dr Lawton was far from problem-free. As newspaper reports made clear, some councillors seemed to be regretting the decision to appoint him, being very free to criticise Herbert and his work. Regardless of how confident he was, he must surely have been aware of a need to watch his back!
Facing the town’s problems
It is obviously impossible to judge how much time Herbert now devoted to his duties as MoH. The post obviously had a high profile compared with his other medical positions in the town, and he now had masters to whom he had to respond, both locally and in London. His priorities had to be carefully juggled. One of his first tasks as MoH was to respond to a request from the Board to report on the way excrement removal was dealt with in Poole. Obviously an important public health matter, but presumably very different to the medical issues he dealt with in his private practice!
He was now charged with inspecting the sanitary condition of both domestic properties and workplaces. This was work conducted very much in the public eye, as any court cases that resulted were seized upon by the local newspapers, where he would be liberally quoted. And again, he had no experience in such inspections before he took up the post.
All MoHs had to present annual reports; his first annual report on the health of Poole, published in early 1879, duly presented the vital statistics of the population. However Herbert had other important messages to deliver. He was highly critical about the unhygienic nature of the water supply from town wells, which were often situated close to cess pits. He urged that the night soil carts not be drawn through the streets of Poole during the day. He also criticised use of baby foods other than milk.
His next annual report as MoH, presented in February 1890, further detailed the work done to safeguard the public health. Again, he highlighted the problems with the water supply. Some parts of the town received no supply at all, in Hamworthy the only supply was from a dirty brook. He urged that legislation be adopted that would give the council the power to enforce proper supply of water to all houses. He also highlighted the high rate of infant mortality; he linked it to the costs of infant life insurance and the fear that people had of applying for medical help via the Relieving Officer. He claimed that parents refrained from claiming medical help for their children because of fears that they would lose their voting rights through being dependent on the poor law. This apparently extreme view was presumably based on some actual experience!
His predecessor Ellis had overseen the creation of Poole’s first hospital, on the waterfront at Baiter. Herbert was now in charge of this small infectious diseases hospital as its sole medical officer. Compare this situation with his previous experiences in large hospitals in London and Liverpool. Decisions had to be made on compulsory admissions of residents and seamen with contagious diseases, arrange their care at the tiny hospital, and ensure disease outbreaks were effectively dealt with. Early on he was forced to deal with a damaged roof on the tiny hospital following a gale, and there were constant concerns about flooding of the building from the high tides in its very exposed situation at Baiter. He worked with the Borough Surveyor to improve its physical condition, especially over damp. In 1878 it was reported to the council that water had even been found underneath the structure during higher tides.
The isolation hospital wasn’t a hospital in constant use, it was used only when those with infectious conditions had to be isolated. The staffing consisted of just one man, known as Hospital Keeper, and his wife, who was expected to provide the nursing care. Herbert appointed a Christopher Wilkins and his wife to these positions in 1878. The annual report stated that only 4 patients were admitted in 1878. Two were cases of enteric fever, one of tubercular meningitis, and one of rotheln (German measles). One of the patients was a seaman removed from a visiting German ship, although the ship wasn’t quarantined.
A further area of possible conflict with some in the town arose from vaccination work. He received a gratuity from the Local Government Board for his work in promoting vaccination in the town, but there were always those who were highly suspicious of such work.
Herbert was a doctor who probably kept up with the medical literature of the day, as is indicated from his contribution in the British Medical Journal (Feb 26 1876 p276). He wrote comparing his use of ether as an anaesthetic in his practice in Poole with his use of chloroform when working in Liverpool. Locally he was a member of the Bournemouth Medical Society, whose members met regularly to discuss professional issues – and have a good dinner.
Downfall of the MoH
Herbert was of course still relatively new to the town, still a comparatively young doctor, and presumably always aware that he was under scrutiny from some on the council. The appointment as MoH was not a permanent one, being subject to renewal by the Council. In November 1880 he had to re-apply for the post, as he now faced competition from a Dr Vernede and a Dr Stainthorpe of Wareham. His doubters amongst councillors now had their chance. During the debate on the appointment, newspaper reports quoted councillors saying that Dr Lawton had possibly done his work too well, and even that perhaps the town was the healthiest in the country and so his health measures were not necessary! A further strange suggestion was that it was only fair that the post should be shared out between the town’s doctors, revealing that not all councillors understood the true importance of the post.
Herbert was backed by 9 councillors in a vote, but Dr Vernede had 10. Herbert had lost his post.
The decision certainly drew criticism. The Poole Telegram newspaper said Poor Dr Lawton has fallen a martyr to duty. He has served the council too well and had to pay the penalty.1 There was adverse comment also beyond the local press, with the British Medical Journal publishing a critical report: We regret to hear that another victim has been sacrificed to the selfishness and cowardice of local authorities, in the person of Mr. H. A. Lawton, the health-officer of Poole. The supporters of this course openly based their opposition to Mr. Lawton on the ground that he did his duty “‘too well”. Although the imputation was indignantly repelled, yet it must be confessed that there seems some justification for the observation of one of the councillors that the new officer was appointed, to “do nothing”. 2
When his annual report was later published, after the decision on his future in the post, the British Medical Journal had more to say: Mr. Lawton’s report on this district is characterised by unusually plain speaking-a quality which we miss too much in reports of health-officers. It needs, however, unusual courage and self-denial for such an officer to say exactly what he thinks, since Mr. Lawton has now shared the fate of many of those who have acted like him, in being ousted from his appointment. 3
So Herbert certainly drew some sympathy for having lost his position as MoH. There was recognition by some at least that he had not been ousted because of professional matters, and clearly there were councillors who had never backed him. But then it had always been a part-time role for him – he had his practice still, plus the other roles he had secured whilst in Poole. His position as medical officer to the Board of Guardians for Hamworthy and Lytchett had been only recently confirmed, and he had secured another role, as medical officer to the local Bicycle Club. His medical practice carried on regardless of the council. As his wife Nessie gave birth to their second son, Edward, that same month, things were certainly not all bad for Herbert..
But this was just his first episode as MoH. He would be back! He was still only 29, and his public health career had only just started.
References:
¹ Poole Telegram 5 Nov 1880 p6
² British Medical Journal 13.11.1880 p797
³ British Medical Journal 4. 12. 1880
See related:
Medical Officer of Health for Poole: the post and the postholders
Heber Dowling Ellis: Poole’s pioneer Medical Officer of Health