By Peter Steere
In my researches into the Medical Officers of Health (MOH) of Berkshire in the late nineteenth century I’ve come across a character that exasperated the civil servants of the Local Government Board.
I first noted Dr William Thomas Garrett Woodforde when researching the Maidenhead Urban Sanitary Authority for which he was MOH. Further investigations at the National Archives revealed that he was Medical Officer for seven Berkshire districts initially, quickly rising to thirteen in later years.
He was first appointed to the Berkshire Combined Districts in 1873 at age 46, with already 23 years medical background together with previous experience as Medical Officer for the Poplar district of London.
The Local Government Board required a copy of the annual report that the medical officers were mandated to provide and in a timely manner, as soon after the calendar end of the year as practicable. Dr John Shea, MOH for Reading and a friend and colleague of Dr Woodforde’s was always punctual with his reports, usually providing the LGB with a comprehensive document within two months of the end of the year. Dr Woodforde took a different approach which quietly exasperated the LGB civil servants.
His report for 1874 was not received until April 1876 and from 1876 onwards there was a steady stream of correspondence from the LGB to Dr Woodforde. By July of 1876 it was noted that his report had not been received for 1875. In November of that year another reminder letter was sent with the closing remark ‘the value of a report….must be materially diminished when it is not furnished until many months after the expiration of the period to which it applies’. A terse note on the back of this copy letter notes that still nothing was received by the 22nd December 1876.
By April 1877 the Board had still received nothing and sent yet another reminder, including the request this time for the 1876 report as well, which is also now overdue. Dr Woodforde responded in October of 1877 saying that he is ‘pushing the printers’ and that it takes a huge effort to compile statistics for thirteen districts. There is a note from the Board on the back of this correspondence asking to meet with him ‘when next in town’ and to tell him that the effort on the compilation of statistics is more or less useless if they are provided so late. The report for 1876 is finally received by the LGB in March 1878. Accompanying notes from the Board say ‘I doubt anything can be done’ and from another, more sympathetically, ‘I doubt too…he has more than one man can do’.
Another excuse letter from Dr Woodforde is received in July of 1878. The note on the back reads ‘The long and the short of it is that his district is much too large for any single M.O.H.: and that some of the duties must be neglected’. A less patient correspondent adds to this in September of that year (after still nothing is received) ‘The result is that the board are paying half the Medical Officer’s salary, while he omits to perform the one duty that brings them into close relation with San. Auth. & enables them to exercise a supervision over the local sanitary administration. This combined district is no doubt an enormous one (pop. 132,513, acreage 368,604) but it is not nearly as large as the Shropshire district from wh. Dr Thursfield sends us excellent reports very regularly and promptly’.
By May 1880 there is a stern letter from the Board ‘The Board feel, therefore that they will be compelled to take serious notice of the matter if you continue to disregard that part of the official instructions which requires each annual report within a reasonable time…’.
This seemingly had no effect and several more reminders were sent. Then, on the 6th of August, a letter was received from Dr Woodforde saying that his daughter has died at the age of 24 after a ten week illness.
With all this procrastination, and even accounting for the personal tragedy of his daughter dying, a picture was emerging of a man that had taken on too much and was probably not serving his communities as well as they could have been. It is true that he had taken a relatively small salary from each district, so their expectations may not have been high, but his total remuneration for the combined districts was £750 per annum – a good professional salary.
The LGB did not act until October of 1889. They finally instigated an investigation; two of the objectives of which were;
‘1) The manner in which Dr Woodforde had performed his duties as Medical Officer of Health
2) To secure if possible on the part of Dr Woodforde a method of reporting that would make his report of real service to the Board as well as to the local authorities’
The extreme patience of the Board in not acting on this tardiness until fifteen years had passed can be partially explained by the developing relationship between local and central government at that time. There were two modes of operation in central/local relations, agency and partnership. Agency simply implements what is decided centrally, which is a hierarchical approach. Partnership looks for a negotiated outcome suitable to both parties and with joint responsibility. The relationship between the central government department and the local authority was not hierarchical. English central government’s relations with local government operated on partnership lines and this is often demonstrated by the remarks in the LGB correspondence1. The language was not dictatorial, and action was taken usually with reluctance.
The report’s findings were surprising. It showed that Dr Woodforde had a very thorough grasp of the public health situation for the districts under his jurisdiction. Dr Woodforde had a ‘thorough and detailed knowledge of the sanitary circumstances of the districts inspected’….
‘an idea can be formed of the very valuable work that has been performed by this officer’……
‘Dr Woodforde has succeeded in getting a large amount of detailed improvement made in the water supply and drainage of houses’……’measures that have no doubt had a very considerable influence on the health of the population’…..’he frequently made use of the presence of disease in a house or a village a reason for getting sanitary defects remedied’.
Dr Woodforde continued in service of the thirteen Berkshire districts until his death in 1908 aged 82. His obituary in the British Medical Journal, clearly written by a friend, is almost a hagiography, but the facts are undeniable. As well as serving as MOH for the combined districts he was Berkshire County Council MOH and ‘was a Vice President of the Incorporated Society of Medical Officers of Health; President of the Society, 1893-4; President of the Home Counties Branch, 1897-8; and President of the Reading Branch of the British Medical Association in 1882 and 1883.’
How much of his reluctance in writing his reports was because he was too busy? How much was to the fact that he didn’t see the point of central government interference perhaps? Or how much was it because he was, as cited in his obituary, ‘A man of many parts, a thorough musician, a devoted lover of flowers and gardening and of everything connected with art and literature, he led a quiet, peaceful life in the midst of the beauties of Nature he loved so well’ who cared very little for the writing of reports….?
Peter Steere is studying for a DPhil in English Local History and is a student at Kellogg College