Based upon actual experience, their views and suggestions were entitled to great weight, and were often of very great value.
One point, and that the most important of all, finds expression in the reports of more than one of them, namely, that the administration of many of the health laws should be compulsory instead of permissive, and that merely declaring a law compulsory without providing the means for making it compulsory was of little use.
What was wanted in London was a real central authority which should have power to make the local authorities carry out the orders of Parliament. This did not exist, for the Metropolitan Board of Works had no such powers, and the Vestries and Districts Boards were independent local governing authorities acknowledging no master and free to obey or disobey Acts of Parliament just as they pleased.
“It has been one of the great faults of our sanitary arrangements and legislation for London,” wrote the Medical Officer of Health for St. James’ in 1872, “that the metropolis has not been regarded as a whole, and that through the ignorance, or carelessness, of one District or Local Board the whole of the others may be put in peril.”
“It is impossible, with our present municipal machinery, in London, at any rate, to exercise all that power which is necessary for the prevention of the spread of infectious diseases.”
And the Medical Officer of Health for Whitechapel in 1873 wrote:—
“If any alteration is made in the constitution of the Metropolitan Board of Works it would be desirable to add to its functions that of a sanitary supervision over the whole metropolis.”
And in 1881 the Medical Officer of Health for Kensington wrote:—