That a Public Health Bill started under such circumstances should be framed absurdly, seeing that those who understood the subject were ignored, and those were consulted who had never done anything well, was nothing but what might have been expected.
One of the provisions of the Bill was, as I have before stated, that every district Poor Law medical officer should be the health officer of his district, and that his reports of insanitary conditions should be sent to the Board of Guardians, many members of which Board would be found to be the principal offenders against sanitary requirements.
This scheme speedily evoked an opposition, and a deputation, representing the British Medical Association, the Social Science Association, and the Poor Law Medical Officers Association, had an interview with Mr. Stansfeld at the Local Government Board. The speakers from the two first Associations having addressed the President, Mr. Stansfeld announced that he had just received a summons to attend a meeting of the Cabinet, but he would leave Mr. Fleming to hear any further remarks that might be made, which would in due course be communicated to him and meet with attention. Being the sole remaining speaker, I said to Mr. Fleming that when I first heard of the proposed utilization of the Poor Law medical officers in the Public Health measures of the Government, I hailed it as a tardy recognition of the valuable services that class of official might render. But when I came to look into the details I saw it would not work, as medical officers would hesitate in affronting their Board of Guardians, many members of which would be found to be the principal offenders against the contemplated Act, and that in the few cases where the parish officers would faithfully carry out the requirements, and thereby offend their respective Boards, they would be sacrificed to the resentment of their members, and if appeal was made for support to the Central Department, such honest men would be called on to resign for not exhibiting sufficient courtesy, &c., and working with their Boards. It was very evident that my observations went home to this Permanent Secretary, but whether they were ever communicated to Mr. Stansfeld is open to much doubt, for his Bill was eventually brought in on the lines he had originally indicated, only to turn out on trial a disastrous and ludicrous failure.
CHAPTER II. THE WESTMINSTER INFIRMARY.
About a twelvemonth after the Act was in operation I appealed, through the medical journals, to my brethren in the provinces as to the arrangements that had been made in their respective localities. A large number of letters from all parts of England and Wales were sent to me, and with the information thus furnished I prepared a paper which I called "Chaos," in which I turned into ridicule the arrangements that had been made, showing that the Department, faithful to its traditions, had made a complete mess of the administrative arrangements. This paper, read at the meeting of the British Medical Association at Sheffield, attracted a good deal of attention both in the medical and general Press. It materially acted in evolving order out of the chaos into which the subject had drifted, owing to the indifference and incompetence of those who had drafted the measure.
In the spring of 1872 I was informed that the alterations and enlargement of the old Workhouse of St. James's, commenced at the time when the Westminster Union was formed, were complete, and that Mr. French, who had been the medical officer of the workhouse and parish of St. James's for upwards of forty years, was about to retire on a superannuation allowance of £200 a year. I was told that the Chairman of the Board, a Mr. Bonthron, a Scotch baker living in Regent Street, had selected a fellow Scotchman, one Dr. S., as Mr. French's successor, and as Mr. Bonthron claimed to be omnipotent at the Board, this gentleman's appointment to the vacancy was considered to be certain. In the course of a few days I heard that a formidable opponent to Dr. S. had appeared in the person of Dr. M., who was also a Scotchman. In due course the election took place, when Dr. M. was elected. This resulted from a protest on the part of certain members of the Board who resented the predominance of Mr. Bonthron. When apprised of the result of the election, I remarked that Dr. M. could not take the office as he did not possess the necessary legal qualifications. On the following Saturday morning a member of the Board told me that a letter had been read at the meeting of the Guardians, held the previous evening, announcing that the election of Dr. M. was null and void, as he held no surgical qualifications. As his election had surprised all the Guardians, because it proved that the Chairman had not the influence he claimed, my informant advised me to apply for the office. At first I hesitated, but upon being urged again I assented. The same evening I called on Dr. M., told him of my intention, and asked him for the support of his friends. To my utter astonishment he told me he had made up his mind to try again. "Nonsense," I said; "how can you get a diploma from the College of Surgeons?" "Oh," he replied, "I have arranged all that; I have a splendid memory, and I remember all my anatomy and surgery." As I had every ground for the belief that he had never attended lectures on surgery, nor attended the surgical practice of an hospital, inasmuch as I had known him ever since he had come to London, I saw that, without collusion with some one in authority, it was impossible for it to be done; but, as he appeared determined, I left him. As soon as it was known that I seriously intended to compete for the appointment, testimonials in my favour were forwarded to me by several eminent physicians and surgeons, by Members of Parliament, among them one of a very flattering character from Mr. C. P. Villiers, M.P., the ex-President of the Poor Law Board, who strongly recommended me to the Board of Guardians, those lady visitors who had known me at the Strand, and others. Two days before the election took place I was surprised by a visit from Dr. M., who called to inform me that he had passed his examination at the College of Surgeons the night before, and now asked me to retire in his favour. On my declining to do as he wished, he said it was very hard I would not, as he had incurred an expense of upwards of £60 to get the diploma. Prior to the election my friends entered into a compact with his supporters to the effect that if I was in a minority on the show of hands my name was to be withdrawn, when they would support him, but if I was in the majority his friends would support me. This occurring, I was elected, to the great surprise of the Chairman, who looked on me as a dangerous person, seeing that I had taken an active part in bringing about the formation of the Union, whereby St. Anne's had been joined to St. James's, which had the effect of somewhat increasing his poor rate assessment in St. James's—for St. Anne's, a poor parish, had considerably improved its position by being put into union with St. James's, which was comparatively a rich one.
Having at this time received an invitation from the Irish Dispensary Medical Officers Association to address them at the College of Physicians in Dublin, I did so, when Sir Dominic Corrigan, Bart., M.P., was in the chair; and I afterwards spent a very pleasant week there, visiting the North and South Dublin Workhouses, the latter having 4,000 inmates, with a large staff of visiting physicians and surgeons, besides resident medical officers. It is one of the finest hospitals in Dublin, and the arrangements for the efficient treatment of the sick poor were in the highest degree creditable to the Irish Poor Law, now the Local Government Board.