08/11/1926: COUNTY MEDICAL OFFICERS OF HEALTH ORDER, 1926

No. 39,176/1926.

WHEREAS by section 21 (6) of the Local Government Act, 1925 , it is provided in effect that every county medical officer of health in and in respect of the area for which he acts, shall :—

(a) be responsible to the board of health and to the council of every urban district in such area for the effective administration of the sanitary laws and of the various powers and duties of such board and of every such council in relation to the safeguarding of the health of the people, the provision of adequate and sanitary housing accommodation and other similar matters ;

(b) advise such board or council, or the county council on any matter where expert advice is required on matters affecting the health of his county or district ;

(c) perform such other duties as may be prescribed and also such other duties as may be assigned to him by such board or council with the consent of the Minister.

AND WHEREAS by section 1 of the Local Government Act, 1925 , it is enacted that in the said Act the expression " prescribed " means prescribed by the Minister for Local Government and Public Health and the expression " the Minister " means the Minister for Local Government and Public Health :

AND WHEREAS by section 21 (5) of the Local Government Act, 1925 , it is enacted that a county medical officer of health shall be a sanitary officer within the meaning of section 11 of the Public Health (Ireland) Act, 1878 :

AND WHEREAS by section 11 of the Public Health (Ireland) Act, 1878, it is provided, amongst other things, that the Minister for Local Government and Public Health shall have the same powers with regard to the appointment, duties, regulation of salary and tenure of office of every sanitary officer as he has in the case of the medical officer of a dispensary district :

NOW, THEREFORE, I, the Minister for Local Government and Public Health, in exercise of the powers vested in me as aforesaid do hereby order and direct as follows, that is to say:—

l. This Order may be cited and referred to as the County Medical Officers of Health Order, 1926.

2. In this Order the expression " local authority " means and includes a board of public health, a board of health and public assistance, and an urban district council.

APPOINTMENT.

3. Every appointment of a county medical officer of health shall within seven days after it is made be reported to me by the Secretary or acting Secretary of the county council.

TENURE OF OFFICE.

4. Every county medical officer of health shall hold office for such period as the county council shall with my approval determine or until he die or resign or be removed by the county council with my consent or be removed by me.

Provided that if the county medical officer of health is temporarily prevented by sickness or accident or other sufficient reason from performing his duties, the county council subject to my approval may appoint a properly qualified person to act as temporary substitute and may pay to such person a reasonable compensation for his services.

5. A county council by whom a county medical officer of health is suspended from the performance of his duties in pursuance of section 11 of the Local Authorities (Officers and Employees) Act, 1926 , shall forthwith report such suspension together with the causes thereof to me and if I terminate the suspension of such officer by the county council he shall forthwith resume the performance of his duties but if I decide not to terminate such suspension the county council may on being informed of my decision dismiss such officer.

6. Where any change in the district of a county medical officer of health, or in his duties or salary, may be deemed necessary and he shall decline to acquiesce therein, the county council may with my consent but not otherwise and after six months' notice in writing given to him determine his tenure of office.

SALARY.

7. The county council shall pay to the county medical officer of health such salary as I shall from time to time approve or direct.

Provided always that the county council may with my approval pay to the county medical officer of health a reasonable compensation on account of exceptional services connected with his duties or the necessities of the area in and in respect of which he acts.

8. Subject to the provisions of sub-section (3) of section 11 of the Local Authorities (Officers and Employees) Act, 1926 , the salary of a county medical officer of health shall be payable up to the day on which he ceases to hold office and in case he shall die whilst holding such office the proportion of salary (if any) remaining unpaid at his death shall be paid to his personal representatives.

DUTIES.

9. A county medical officer of health shall in addition to any duties imposed upon him by statute perform the following duties :—

He shall—

(1) inform himself respecting all influences affecting or threatening to affect injuriously the public health in his area.

(2) inquire into and ascertain by any means at his disposal, the causes, origin and distribution of diseases in his area, and ascertain to what extent the same have depended on conditions capable of removal or mitigation.

(3) by inspection of each county health and urban district in his area both systematically at certain periods and at intervals as occasion may require keep himself informed of the conditions injurious to health existing therein, and regularly report the same to the local authority concerned.

(4) advise each local authority in his area on all matters affecting the health of their District and on all sanitary points involved in any action taken or contemplated by them, and in cases requiring it he shall certify for their guidance or for that of Peace Commissioners or for the purpose of legal proceedings any matter in respect of which the Certificate of a medical officer of health or a medical practitioner is required as the basis of or in aid of sanitary action.

(5) advise each local authority in his area on any question relating to health involved in the framing and subsequent working of such bye-laws and regulations as they may have power to make, and as to the desirability of their adopting any of the provisions of the Public Health or other Acts applicable to their District which it may be optional for them to put in force.

(6) on receiving information of the outbreak of any infectious or epidemic disease of a dangerous character in his area, visit, without delay, the place where the outbreak has occurred, and inquire into the causes and circumstances of such outbreak, and in case he is not satisfied that all due precautions are being taken, he shall instruct the persons competent to act as to the measures which may appear to him to be required to prevent the extension of the disease and take or direct to be taken such measures for the prevention of the spread of the disease as he is legally authorised to take or direct to be taken.

(7) (a) receive and take the necessary action upon the certificates and notices given under the Infectious Disease (Notification) Act, 1889, and in all action taken by a local authority under that Act in his area and under the Infectious Disease (Prevention) Act, 1890, he shall be substituted for the Medical Officer of the Dispensary District, in accordance with the provisions of section 18 of the Public Health (Ireland) Act, 1896, as amended by section 21 (8) of the Local Government Act, 1925 .

(b) enter or cause to be entered both the certificates and the notices in a book provided by the appropriate local authority, to be called the Register of Notifications, and to be kept in the office of the local authority for that purpose.

(c) keep any other books or forms in connection with the Infectious Disease (Notification) Act, 1889, which I or the local authority may from time to time consider necessary.

(8) administer any regulations made by me for the time being in force in his area for all or any of the purposes specified in sections 148 and 149 of the Public Health (Ireland) Act, 1878, or the Public Health (Regulations as to Food) Act, 1907, so far as the same relate to or concern his office.

(9) forthwith report to me any case of plague, cholera, smallpox, typhus fever or puerperal fever, or any serious outbreak of disease in his area which may be notified to him or which may otherwise come or be brought under his notice.

(10) shall attend all such meetings of a local authority as they may direct and when required any meeting of the county council and advise them on any matter where expert advice is required on matters affecting the health of his county or area ; and shall attend all important sanitary or other prosecutions which relate to or concern the duties of his office.

(11) direct and superintend the medical officers of health and sanitary officers in the performance of their duties in his area and on receiving information from such officers that his intervention is required in consequence of the existence of any nuisance or other conditions injurious to health, or of any overcrowding in a common lodging house or other house, he shall, as early as practicable, visit the place and take, or direct to be taken, such steps as he is legally authorised to take, or direct to be taken, and as the circumstances of the case may justify and require.

(12) in any case in which it may appear to him to be necessary or advisable, or in which he shall be so directed by the local authority, inspect and examine any animal, carcase, meat, poultry, game, flesh, fish, fruit, vegetables, corn, bread, flour, or milk, or any other article to which the provisions of the Public Health Acts, in this behalf apply, exposed for sale or deposited for the purpose of sale or of preparation for sale, and intended for the food of man, which is deemed to be diseased or unsound, or unwholesome or unfit for the food of man ; and if he finds that such animal or article is diseased or unsound or unwholesome, or unfit for the food of man, he shall give such directions as may be necessary for causing the same to be dealt with by a Justice of the District Court according to the provisions of the statutes applicable to the case.

(13) inspect from time to time and exercise general supervision over slaughterhouses, cold stores, dairies, cowsheds, milkshops, and all other premises in his area where food of any kind is prepared, stored or otherwise dealt with for sale or preparation for sale and intended for the food of man, and advise the appropriate local authority on the effective application of the provisions of the Public Health Acts and other Acts, Orders and Regulations in force in that behalf with regard to food which is diseased, unsound or unwholesome, or unfit for human consumption.

(14) inquire into any offensive process or trade carried on in his area and report to the appropriate local authority on the means for the prevention of any nuisance or injury to health therefrom.

(15) perform the duties mentioned in sections 132 and 133 of the Factory and Workshop Act, 1901.

(16) be responsible for the general supervision of any approved tuberculosis scheme in such area with a view to co-ordinating the work of the officers engaged in that scheme, and securing the effective application of the provisions contained in the Acts, Orders and Regulations in force relating to the notification, prevention and treatment of tuberculosis.

(17) be the medical officer of the county council for the purposes of the Midwives (Ireland) Act, 1918, and perform the duties of such officer thereunder.

(18) be responsible for the organisation, supervision and administration of the measures adopted by each local authority in his area for attending to the health of expectant and nursing mothers and children under five years of age and for the general administration of the Notification of Births Acts, 1907 and 1915.

(19) advise as to the organisation and supervise the operation of any scheme for promoting the welfare of the blind in force in his area in accordance with section 2 of the Blind Persons Act, 1920.

(20) advise as to arrangements required for the prevention and treatment of venereal disease in his area and administer any scheme adopted for that purpose with my approval.

(21) advise as to the arrangements for school medical inspection in his area under the Public Health (Medical Treatment of School Children) Act, 1919, and without prejudice to any provisions contained in an approved scheme afford supervisory direction to officers employed in connection with a scheme of school medical service.

(22) direct and supervise the administration of the Vaccination (Ireland) Acts and advise each local authority in his area of the measures necessary to be taken to secure their enforcement.

(23) perform the duties of a medical officer of health under Paragraphs I and II of the Housing of the Working Classes Act, 1890.

(24) report in writing monthly or more frequently if required to each local authority in his area his proceedings and the measures which may require to be adopted for the improvement or protection of the public health in their district and in like manner report with respect to the sickness and mortality in their district so far as he has been enabled to ascertain the same, and on the discharge of their duties by the medical officers of health and sanitary officers in their district, and from time to time as occasion may arise report to the appropriate local authority in his area on any matter arising out of the performance of his duties.

(25) forward to me by post every week in time to ensure its delivery on Monday or the morning of Tuesday, at the latest, a return, in such form as I may from time to time require, of the number of cases of infectious disease notified to him during the week ended on the preceding Saturday.

(26) furnish to me such returns of sickness and disease as I shall from time to time require.

(27) furnish me with a copy of any special report which he may make to a local authority in his area.

(28) (a) as soon as practicable after the 31st day of December in each year make an annual report to the county council up to the end of December on the sanitary circumstances, the sanitary administration and the vital statistics of his area, which shall in addition to any other matters upon which he may consider it desirable to report or upon which I may require him to report contain the following sections :—

(1) a section as to the influences, if any, threatening the health of his area, the prevalence of infectious or epidemic diseases, and the measures taken for their prevention.

(2) a section as to the action taken or which he has advised a local authority to take for the prevention of the spread of disease or on matters affecting the health of his area.

(3) a section as to any inquiries general or special which he has made into any matters affecting the health of his area.

(4) a section as to the sufficiency and quality of the water supply in his area and of its several parts.

(5) a section as to the character and sufficiency of the arrangements for the drainage, sewerage and sewage disposal in operation in his area.

(6) a section as to privy, water closet and other closet accommodation of his area.

(7) a section as to the character and efficiency of the arrangements for the cleansing of earth-closets, privies, ash-pits and cesspools in his area.

(8) a section on the measures taken for the notification, prevention and treatment of tuberculosis and the administration of the Tuberculosis (Ireland) Acts, 1908 and 1913.

(9) a section on the administration of any scheme in force in his area for the prevention and treatment of venereal disease.

(10) a section on the administration of the Vaccination (Ireland) Acts.

(11) a section on the administration of the Midwives (Ireland) Act, 1918.

(b) Send to me two copies of his annual report and also one copy thereof to each local authority in his area.

(29) in matters not specifically provided for in this Order, observe and execute all orders, directions and instructions that I may hereafter make issue or give and all the lawful orders and directions of each local authority in his area which are respectively applicable to his office.

GIVEN under My Seal of Office this Eighth day of November, in the Year of Our Lord, One Thousand Nine Hundred and Twenty-six.

(Signed) SÉAMUS DE BURCA,

Minister for Local Government and Public Health.