Brit. J. industr. Med., 1971, 28, 315-322

Some aspects of the early evolution ofthe Appointed Factory Doctor Service*

JAMES A. SMI LEYDepartment of Social Medicine, Queen's University, Belfast

Smiley, J. A. (1971). Brit. J. industr. Med., 28, 315-322. Some aspects of the early evolution ofthe Appointed Factory Doctor Service. The appointment of certifying surgeons marks thebeginning of the recognition by the State of its responsibility for the supervision of the healthand welfare of young people in industry. The importance of the role played by LeonardHomer, one of the first four inspectors of factories, is discussed. Some of the problems andvicissitudes of the service in the 19th century are outlined and it is suggested that the systemis inappropriate to the needs of the present. Legislation which would integrate all the agencieswhich are concerned with the well-being of young people, including the Appointed FactoryDoctor Service, should be actively considered.

James Mackenzie. whose life and work we honour,was General Secretary of the Y.M.C.A. NationalCouncil in Scotland. His contacts with workingclass boys led him to believe that legislation toprotect the health of the worker could be madeeffective only through education by leading him toan understanding of the hazards involved. So in 1922Mackenzie was instrumental in forming in Scotlandthe Industrial Education Council 'with the object(among others) of educating the industrial workeron the diseases and sicknesses to which they areliable with a view to their mitigation and pre-vention'.1 Such was the interest aroused in Scotlandthat requests for an extension of its activities to therest of the country were met (with the support ofProfessor J. Glaister and Sir Robert Phillips) by itsconversion to The Industrial Health EducationSociety for the United Kingdom.2 Its work wasmainly carried out by the organization of talks andlectures all over the country and some idea of thescope of its activity may be gauged by the fact thatan average of 400 talks were being given each year.3As the result ofchanges brought about by the 1939-45war it was decided to wind up the Society. In itslater years the British Medical Association had*B.M.A. Mackenzie Industrial Health Lecture 1970,delivered at Trinity College, Dublin.

cooperated actively and had given the Society thehospitality of B.M.A. House for its headquarters.Mackenzie was in failing health, so at a meetingheld in 1944 in Edinburgh where the original Societyhad been founded, it was decided to hand over to theB.M.A. the remaining funds for the establishment ofa lectureship on the relation of health to industry,to be associated with the name of James Mackenziewho had started the Society and continued as itsosganizer. He died in 1944 and this lecture has beendelivered biennially since 1946. This brief outline ofthe work of the man whom now we rememberreminds us that advances in industrial health andwell-being have been achieved by the cooperation ofdoctors and laymen of many different disciplines. Itis an interesting study to observe how the frameworkfor these achievements has been gained.

Since the 16th century it had been accepted thatthe primary duty of statesmen was to safeguard theprosperity and well-being of the nation as a whole.The idea that it was proper for the Government toregulate the minutiae of commercial activities wasfully accepted. With the rise of the Factory Systemand the formulation of the doctrine of laissez-faire,supported by the grim economic theories of AdamSmith, Ricardo's philosophy of self interest, and thepessimistic population studies of Malthus, human

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selfishness was restrained only very occasionally bythe working of conscience. Whereas the mediaevallabour statutes, e.g., Statute of Artificers 1563, andthe ordinances of the craft guilds had given somemeasure of protection to the workers againstexploitation, with the disintegration of mediaevalsociety many of these conventions were no longerrelevant. The fact, of course, is that the laws werenot specifically designed for protection of the work-ing population. They were designed to promote theinterests of the masters and there was a presumptionthat what was beneficial for them was in the interestsof all. 'The guild prohibitions of work at night seemto have been partly due to the desire to maintain ahigh standard of quality in the product which mightbe endangered ,by night work, the prescription ofholidays partly to religious motives and bothprobably also to the idea that as the normal citizenwent to church on festivals and slept at night, it wasunfair that he should be injured in his business bythe competition of those who infringed these orderlycustoms.'4 The Elizabethan Poor Law of 1601required that destitute children and orphans shouldbe apprenticed to some trade. Houses of industryfor instructing these children in spinning and weavingwere a favourite charitable hobby of the 17th and18th centuries and the children were subsequentlybound apprentice to employers. There was adomesticity and intimacy about the arrangementswhich disappeared with the coming of the factorysystem-although indeed the custom persisted muchlonger in Ireland, probably, of course, because thefactory system was so much later in coming to thiscountry. Bishop D'Arcy, whom some older membersof this audience may remember, in his autobiographydescribes with approbation two such workshops stillin existence at the beginning of this century whichhad been set up in Co. Monaghan by the wives oftwo clergymen for the instruction of girls, one inthe art of crochet lacemaking and the other in themanufacture of Carrickmacross and Inishmacsaintlace.5With the advent of water and later of steam power

and mechanization the aggregations ofpeople leavingthe land to settle near the sources of power, the riseof the mercantile class, the ruthless, hard and selfishexploitation of the labouring classes, and the re-jection by most millowners (with a few honourableexceptions) of any responsibility for the well-beingof their workpeople, their condition, especially thatof the children, rapidly deteriorated. It was when theinterests of the employing classes around Manchesterwere threatened by epidemic disease originating ata cotton mill at Radcliffe that the local justices in1784 took action. They invited Dr. Thomas Percival,a leading physician in the area, to 'investigate thenature and the circumstances of the outbreak'.With his colleagues and leading citizens he formed

the Manchester Board of Health. This Board,through authoritative reports. made recommen-dations for the control of such epidemics by theestablishment of isolation hospitals. They alsourged the need for the improvement of environ-mental conditions in mills and factories and for thediminution of working hours, especially for childrenand women. In pursuance of these objects, theGovernment in 1802 passed the Health and Moralsof Apprentices Act,6 the First Factory Act. Thisaudience does not need to be reminded of the plightof the children at that time. Because of the comingof mechanization manufacturers found that manyprocesses could readily be carried on without thelabour of men. With growing male adult unemploy-ment the demand for juvenile labour increased, andbecause of poverty, in the manufacturing towns,parents reckoned each child a supplement to theirincomes. In the southern towns and in agriculturalparishes the local authorities disembarrassed them-selves of a burden by selling pauper children, underthe name of apprentices, to Lancashire and Yorkshiremanufacturers. These children, often housed indormitories attached to the mills, were virtuallyunprotected. They entered the mills at an incrediblyearly age. Daniel Defoe mentions 4 years and aMr. John Moss gave evidence to the Sir RobertPeel Committee in 1816 that the apprentices in aPreston mill mostly came from London and werebetween the ages of 7 and 11. Children of this agewere easily cowed into submission and they wereentirely at the mercy of their employers who,because of the prevailing philosophy and practice,assumed them to be free agents. The reports of thevarious commissions and committees in which theVictorian era abounds present horrifying evidence ofthe disastrous effects of the factory system. Itastonishes me that Sir Arthur Bryant could entitlehis book on the period 'The Age of Elegance'-aperiod which the Hammonds felt impelled to call'The Bleak Age'.The Act of 1802 required that apprentices should

not be employed for more than 12 hours a day normust they work between 9.00 p.m. and 6.00 a.m.They were to receive instruction in reading, writing,and arithmetic and they were to go to church oncea month. They were to have a suit of clothes eachyear and they were not to sleep more than two in abed. Factories were to be whitewashed twice a yearand the windows were to be sufficient to secureadequate ventilation. The factory premises were tobe inspected by visitors appointed at the QuarterSessions and if any infectious disease occurred inthe factory the visitors were empowered to call ina physician who was to make periodical reports onthe progress of the disorder, his fees to be paid bythe mill owner.7 I find this last provision to beof some passing interest in view of the correspon-

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dence which 47 years later passed between the HomeOffice and J. A. Stuart, one of the first factoryinspectors. On 8 January 1849 Stuart, having re-ceived a communication from an under secretary,H. Waddington, concerning an outbreak of cholerain Glasgow, replied that the 'only gentlemen whoalone are officially in discharge of any duty con-nected with the Factory Acts, viz., Mr. CharlesBalfour, subinspector of factories, and MessrsDavid Cunningham, Joseph Fleming, and JamesStewart, certifying surgeons, . . . I have directedthem to give their immediate and best assistance inendeavouring to check the destructive progress ofthe epidemic cholera. . . They are trustworthyand intelligent men.'8

Alex Bain, assistant surgeon to the GeneralBoard of Health on 15 September 1849, writing toSir George Gray at the Home Office, said 'thearrangements made in Glasgow and Dundee for thedaily examination of the operatives in each factoryduring the prevalence of cholera were of utmostimportance in preventing incipient cases of cholerafrom passing into the malignant and fatal stages ofthe disease and I am to express the desire of theBoard that similar arrangements be made, throughthe Inspectors for the factories in those places ofYorkshire and Lancashire at present affected orthreatened with an attack of the disease.'9 On2 October 1849, an epidemic having broken out inLancashire and Yorkshire, the Home Office askedthat 'the same plan be adopted which was carriedout in various towns in Scotland under the directionof Mr. Stuart but that they are not aware in whatmode the certifying surgeons in those towns wereremunerated for their services.'10When Leonard Homer wrote to his certifying sur-

geons he added 'as you will perceive, the letterfrom the Under-secretary of State says nothing as toyour remuneration for such visits but I think youneed have no doubt of the Government doing allthat is just and right in that respect'. It might be aninteresting exercise sometime to find out howindeed they were remunerated, by whom they wereremunerated, and why the principle established inthe 1802 Act was in doubt.My purpose, however, in spending so much time

on the 1802 Act, 'an Act for the Preservation of theHealth and Morals of apprentices and others,employed in cotton or other mills and cotton andother factories' is not to discuss the amount ormethod of remuneration but to show that even fromthe early days of factory law those concerned werelegislating not only to improve working conditionsand make them more safe, not only to safeguardthe health of the community in general, they weredrafting a Bill quite evidently acknowledging thatthe morals and the education of young people werematters of interest, concern, and responsibility. It

is in the tradition of factory legislation that peopleare regarded not as being physical automata or mere'factory hands' but in all their fullness as humanbeings. The State, in theory at least, seemed toaccept one of the principles later enunciated in theConstitution of the World Health Organization that'Health is a state of complete physical, mental andsocial well-being and not merely the absence ofdisease or infirmity'. . . . 'Healthy development ofthe child is of basic importance; the ability to liveharmoniously in a changing total environment isessential to such development'.'2The 1802 Act, however, was observed mainly in

the breach and there is considerable evidence notonly that many magistrates were unaware of itsprovisions but that the visitors when appointed,being usually derived from the social class of theemployers., performed their duties in a mostperfunctory manner. Nevertheless its enactmentwas of great importance for it re-established that theState had a right, indeed a duty, to supervise factorylife.The next half century was a period of almost

unparalleled political activity and agitation in whichpeople like Michael Sadler, Robert Owen, RichardOastler, Parson Bull of Byerley, Lord Ashley (laterShaftesbury), and many others espoused the causeof, in particular, the factory children. It was a periodof great social distress and great economic upheaval,a period when people in large numbers were leavingthe countryside to live in and create cities; a periodwhen the old social order was breaking up and therewas no clear vision of what the future held, a periodwhen men and women tended to be depersonalizedand were being forced into the discipline of themachine. John Hind, a partner in Mulholland's millin Belfast, giving evidence to the Royal Commissionof 1833, said 'The people here are more irregular intheir habits of punctuality and they are as yetscarcely accustomed to the Factory System'.13When I accepted the invitation to deliver this

lecture, knowing that it would be heard by thisaudience in Dublin, I sought to discover if con-ditions or circumstances in Ireland might have hadany influence on the continuing story of factorylegislation in these islands. I should have knownbetter-for the impact of the industrial revolutionwas not felt in Ireland for many years after its evilswere apparent to all, especially in northern England.It is quite interesting to read the evidence given tothe 1833 Factory Commission in Belfast. It paints apicture which is very much less discreditable thanthat of the dark satanic mills of Lancashire. True,James Stuart, who took the evidence (and who laterbecame one of the early factory inspectors inIreland) in his report, said that Crossan's mill inBelfast was 'one of the worst specimens of cottonmill in point of general arrangement I have seen

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anywhere and ought to be indicted but that ofBoomer & Co. is the reverse-although not withoutgrounds for criticism'.'5 A colleague of Stuart, Mr.Mackintosh, took the evidence at Mulholland'smills and his comment was, 'This is a very favourablespecimen of the lately erected mills in point of in-ternal arrangement and ventilation and arrange-ments for cleanliness. A medical gentleman visitsthe works at the instance of the proprietors, twicea week.15 In point of fact we find that elsewhere inIreland doctors were engaged by employers to lookafter their workpeople. John Martin, in his evidence,refers to a Dr. Wilson at Stevenson's mill, andJames Stuart took evidence from a Mr. Shaw 'whois the medical practitioner at Killyleagh whoseprofessional services are paid for by the companyfor all the workers whatever their complaint',"' andif one looks at the evidence about flogging (and it isclear that enforcement of discipline by this meanswas the rule elsewhere) it seems to have been usedin Belfast only in exceptional circumstances. JohnHind, to whom I have already referred. said 'It doesnot matter what the offence is, positive instructionsare given to overlookers not to lift a hand againsta child'. Similar evidence was given elsewhere inIreland. There was, however, one statement whichpuzzled me. It was made by Richard Reade,'7 themanager of Whiteabbey Mill, 'no corporal punish-ment but by a pair of light taws is allowed but neverexcept in extreme cases':-the Commission goes on'he, Mr. Reade, thinks the people are very healthy,but he cannot say so much for their morals: that heconsiders the people as sober but wherever so manyfemales are congregated together he conceives thattheir morals are not so strict'.

It is not my claim that in Ireland at this time (or,indeed, at any time) all is sweetness and light. I amsimply reiterating what I should have known at theoutset, that we in Ireland had very little influence onearly factory legislation.The fact was that in the main our industry was

domestic in character or, at most, primitive in itssources of power. Gribbon'8 states that the moststriking feature of the Ulster countryside in theperiod 1750-1850 must have been its intense activity'for water power was harnessed to all kinds of useslong after it had been replaced by steam in England-and the reason is not far to seek. Marshall,19the great flax spinner (1789-1885), commented in1825 that the coal which cost him £1 850 in Leedswould have cost him £9 000 in Belfast.

It is not uncommon to find sophisticated folk ofthe 20th century sneering at the alleged pomposity,hypocrisy, and alleged cocksureness of the Victorian,but there is no doubt that our forbears had a self-confidence and a will to work which today we lack.The first report of the Central Board was presentedon 25 June 1833, only nine weeks after the com-

mission had been set up (Commissions had beensent to take evidence in all parts of the kingdominstead of what had formerly been the practice-that of bringing witnesses to London)-nor was theGovernment of the day slow to act, for on 9 August1883 there was introduced and Parliament passed'An Act to regulate the labour of Children andYoung Persons in the Mills and Factories of G.B.'.

It would be a fascinating exercise at another timeto attempt to describe all the currents and cross-currents which brought this Bill to the StatuteBook. For many years the Irish Members hadprofound influence on British legislation; theirsupreme interest was to have the Act of Unionrepealed and to obtain for the Catholics and non-conformists relief from oppression. All else was ofminor consideration. It will not surprise you,therefore, to learn that Dan O'Connell, the greatemancipator, voted against the Bill. There is littledoubt that he had made a bargain with the Liberals,who opposed both this and the Ten Hour Bill. Youmight thinkthat politics nowadays are robust enough.Listen to this-Blackwood's Edinburgh Magazine,20referring to O'Connell, said 'The Sordid Judas ofthese days betrayed them for gold. Three days afterthe traitor had fulfilled the conditions of the con-tract-a purse of £700 from the Unitarian andDissenting Mill owners and others was presented tohim. It had been kept back . . . until the noxiousreptile had acquitted his engagement'. RichardOastler21 felt equally indignant and said ofO'Connell, 'He voted against the friends of thefactory children and received his reward-the"Blood Money" paid to him by the Liberal tyrants'.The intricacies of Irish politics have always baffledour neighbours!

This, of course, is of only passing interest. Peel'sAct of 1802 had required that apprentices shouldreceive some measure of instruction during workinghours but this affected only a small proportion ofthe children employed in mills and factories. Aslate as 1842 one of those taking evidence for theChildren's Employment Commission, T. Martin,Esq.,2' reported that in the coal mines in Co. Tyroneyoung people appear to be employed as early as 8or 9 years of age and he goes on to suggest that'parents are pushing their children into Collieryemployment at an earlier age, because of the legalrestriction from sending them to the neighbouringfactories in which they would be exposed to far lesshardship and hazard'. On the other hand, ofcourse, must be mentioned the interesting commentof another commissioner, Mr. Roper,22 on theyoung workers of the Dromagh colliery: 'Theirappearance was very healthy: they said their workwas hard and that they must live well.' 'In the coalmines of Ireland a fixed time appears to be allowedat least for dinner and it was stated by one witness

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that at the Dromagh Mines, the extraordinary timeof two hours is allowed for this meal and that theworkpeople ascend the shaft to eat it; a custom, asfar as it is prevalent, quite peculiar to this part of theU.K.' The Act of 1833 applied to all boys and girlsin the textile industry and in it we see the first faintglimmering of the idea of an educated working class.Another significant feature was the creation of a

-special department of central government for thepurpose of administering the Act-the embryoFactory Department. Mr. (later Sir Edwin)Chadwick is credited with this proposal but it isdifficult in reading the papers of this period to resistthe notion that Leonard Homer was responsiblefor the emphasis on education.

Leonard Homer23 came from a distinguishedEdinburgh family. His father was a linen manu-

facturer and his brother Francis an influentialmember of Parliament representing St. Mawes.Educated at Edinburgh High School and EdinburghUniversity where he studied chemistry, Leonardsoon became well known as a mineralogist andgeologist and in 1808 was elected a Fellow of theGeological Society of which he later became Pre-sident. Five years later he became a Fellow of theRoyal Society. After some years in London he re-

turned to Edinburgh and in 1821 founded the Schoolof Arts there for the instruction of mechanics andthus, according to the great Lord Cockbum, was

'indirectly the founder of all such institutions'. In1827 Homer was invited to London to assist inorganizing the London Institution and in the follow-ing year became warden of London University atits opening. He resigned this office in 1831 partlyon account of ill health and went with his familyto live at Bonn where he continued his studies ingeology. In 1833 he was appointed one of the com-

missioners to enquire into the employment of child-ren in factories and he was until 1856 one of thechief inspectors under the Factories Acts. One hasonly to consider his career, the range of hisinterests, his association with educational institu-tions, or one need only read his letters to hisfamily collected in a memoir by a devoted daughter,or the pamphlets24 he wrote outlining in detail butin simple terms the educational requirements of the1833 Act, to realize how deeply committed LeonardHomer was to the education of the common people.By 1835 he was becoming disillusioned about theeffectiveness of the Act but in his Report he stillinsisted, perhaps in a lower key, 'I am convinced ofthe paramount necessity of legislative interference toprevent the children in the factories from growingup in a state of barbarous ignorance'.25 Such wasthe man who as one of the first four factoryinspectors brought his lively cultured intelligence tobear for several years on the problems of industriallife, especially as they affected the young people of

this country from 1833 until 1836 when the factorydistricts were reorganized. The northern part ofIreland was only part of his responsibility for hisdistrict included also the whole of Scotland,Cumberland, Westmorland, Durham, and North-umberland. Nevertheless he made his first visit toIreland within a very few months of his appointmentand in his letters to his family from Belfast he writesof the good reception he had there from the millowners and 'their willingness td cooperate in theeducation of the children'.26 Perhaps he was undulyinfluenced in Belfast by a kindred spirit, Mr. Lepper,who not only was manager of Stevenson's mills butwas also secretary of Belfast Academy-the firstschool for secondary education in Belfast-for thefollowing year both Homer and Howell, theinspector for Southern Ireland, reported that'nowhere were the educational provisions of theAct complied with'.27 Homer returned to Ireland inJune 1835 and, judging by his letters and reports, herevelled in his work and his enjoyment of thecountryside. Travelling long distances by pony andtrap or horse and sidecar over poor roads, he tookhis opportunities for meeting and observing manyinteresting people. On 5 June 1835, he found him-self in a little village in the Mourne mountains,Hilltown, and was invited to dinner at the home ofthe local doctor, Dr. McDonnell. There Homer metDr. Crolly, the Catholic Bishop of Down, who hadjust been elected Archbishop of Armagh and whosefriendly spirit and great scholarship greatly im-pressed him. A day or two later he was in Killyleagh,some 30 miles away, inspecting a cotton factory(which he found in the highest order) and we learnthat Mr. Martin, the owner, personally drove himover to Downpatrick some eight miles away wherehe hired a car to bring him to Castlewellan, the siteof the first steam-powered mill in Ireland. There hewas astonished that flax could be spun into suchfine yarn as would make cambric and was lunched bythe owner, Mr. Murland. Homer was a man notonly of great learning but obviously of great tact.26The 1833 Act (passed the year after the great

Reform Act) not only made provision of sorts forthe elementary education of children and theappointment of factory inspectors, it introducedsurgeon's certificates as a means of verifying age.W. R. Lee,28 in his brilliant, illuminating, andthoroughly documented article 'Robert Baker: TheFirst Doctor in the Factory Department', has out-lined the story of the early certifying surgeons andthe problems with which they were confronted so itis not necessary for me to recapitulate. Baker himselfwas attacked by an alderman Sadler in a speechreported in the Birmingham Daily Post29 of 16October 1869 wherein it was alleged that theassiduity with which he enforced the Factory Actwas due to the fact that Baker pocketed the fines

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for successful prosecutions. Baker30 thereupon wroteto the Home Office asking permission to prosecutean action for slander because in fact the fines weredispensed for the upkeep of the school system.Suffice it to say that since their appointment therehas been agitation, which flared up from time totime, to have the system abolished. Sometimes theattack was on individual surgeons whose probitywas held in question-a Dr. Shearman of Rotherhamwas dismissed following complaints by an inspector(Redgrave). On 9 January 1854 Redgrave3l wrote toHon. Henry Fitzroy, M.P., at the Home Office,'and 1 would beg to state that it is by no meansdifficult with the exercise of common observation todetermine the age of children, that at the age mostespecially of 13 certain well defined physiologicalconformations appear in regard to teeth, voice,aspect etc. which are almost accurate indication ofthe attainment of that age, that if certifying surgeonswere to pronounce their opinion upon observationalone and to close their ears to the representationsof those interested in the passing of the children,they would seldom err . . . and I would un-hesitatingly affirm that not one of the 300 certifyingsurgeons would aver that the appearance of a childunder 12 could be mistaken for that of a child of13 years of age'. Homer himself had writtencopiously on the subject of ascertaining the age ofchildren by an inspection of their teeth. In a letter32from Manchester on 30 October 1837 he writes tohis wife 'I am striving with the difficulty of ascertain-ing the real ages of the children from physicalcharacteristics, and have had consultations withmany doctors upon the value of the teeth as a test-I mean the growth of the second teeth-and I believefrom all they say that it is the most unerring we canuse. I am becoming rather knowing in that way forI have looked into 500 little mouths lately. I supposeit has got wind, for when the doctors and I go roundthe mills and call any to us that appear too youngfor their work, they sometimes come running withtheir mouths open and turn up their little heads with-out being told'.Sometimes the attack came from the workpeople;

the Accrington and District Trades Council33 sent acomplaint to the Home Office about children havingrepeatedly to pay for passing the surgeon. The matterwas referred to the Acting Chief Inspector ofFactories who reported that the situation was evenworse than that outlined for 'learners who werebeing paid no wages were required by occupiers topay the fee'.About the same time (1845) the Home Office

received a memorial from the Glasgow occupiers34that the fee should not exceed sixpence. This, ofcourse, was opposed by the surgeons. In the eventthe maximum fee was fixed at one shilling plus oneshilling per mile travelling expenses. If more than

10 certificates were granted the fee for each certificatewas to be sixpence.

There is in the Public Record Office the dossier ofcorrespondence initiated by Walter S. B. McLaren,M.P.,35 on 9 November 1888 about the appointmentof Dr. Atkinson as certifying surgeon at Crewe. Itwas alleged that Atkinson had been engaged by thedirectors of the London and N.W. Railway as worksdoctor and that he was receiving from them £700per annum as remuneration. Reading between thelines it seems likely that there was a personalvendetta against Atkinson although the ostensiblereason for the complaint against him was that therewas 'no confidence in his fairness and impartiality'.In the end it was deemed that the doctor was 'nottechnically disqualified but that it was inexpedientthat he continue to be a certifying surgeon and theinspector should arrange with him to resign'. It waslearned subsequently that Atkinson received only£80 from the company for which he supplied drugsand dressings, and the rest of his remuneration wascollected by the company from the men and passedon. It will be remembered that at first the mainfunction of the certifying surgeon was to declarethat the young person appeared not to be below theage of 10 years. This was necessitated by the factthat the compulsory registration of births did notbecome operative until 1837.On 29 July 1853 a Mr. George Robinson336 wrote

from Huddersfield to Lord Palmerston complainingbitterly about being called to pay a surgeon tocertify 'a matter of opinion when the absolute factat much less cost could be obtained by an applicationto the Registrar. There can now, My Lord be noreason why the system should continue except as apiece of patronage for the inspectors who have theright of appointment, as the real age can now beascertained and a certificate obtained for a shillingwhich would last the child through life . . . I neednot caution yourLordship against the present attemptof designing demagogues' and protectionists' spite toso far curtail our future operations as perhaps finallyto sap and undermine the very growth and found-ations of trade.

I am, Your Lordship'svery obedient servant,George Robinson'

This letter was sent to Leonard Horner37 whodeclined to venture an opinion until he had had anopportunity of consulting his colleagues. One ofthese was Howell38 in Southern Ireland, and so faras I can discover this is the only occasion on whichevents in Ireland had any influence on the story ofthe certifying surgeons, for he writes from Dublin on1 August 1853 '(1) beg to say that the RegistrationAct does not extend to Ireland and therefore Mr.Robinson's suggestion is inapplicable to this part ofthe United Kingdom, neither does it meet the case

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of Irish born children working in English factories'.And so the role of the certifying surgeon con-

tinued, to which was added the duty from time totime of investigating the very many accidents whichperpetually marred industrial life during the 19thcentury. But resistance persisted, though the FactoryCommission of 1875 recommended that the systembe continued. It flared up acutely again in 1891,criticism coming from what nowadays we mightthink to be very unlikely sources. On 9 March 1891there appeared in the Manchester Guardian a letterfrom T. P. Sykes, honorary secretary of the HalfTime Council of Teachers from Bradford. Sykes39complained that 'certifying surgeons are of no

value' and that he had 'never known of a singleinstance of a child being rejected as being unfit forwork'. On the other hand, a memorial from themanufacturers and employees in Smethwick50 was

presented to the Home Office on 25 March 1891 inwhich it was testified 'that the examination by thecertifying surgeon as to the physical fitness for workof young persons and children must be an essentialprovision in any Factory Act.' There is an interestingnote pencilled in the margin of this petition to theeffect that this is an important and significantdocument, but for the present 'I am not to be takenas accepting its arguments'. The initials I have notbeen able to decipher. The correspondence columnsof both the provincial and national press (not tospeak of the medical journals in which also appearedlengthy editorial comment) were lively on the issuebut when the matter came before Parliament, TheEconomistCl found itself impelled to comment on

'the extraordinary ignorance displayed by themembers who took part in the debate on the 2ndreading of the Bill . . . for the amendment of theFactory Act'.'1 It could have been written 80 years

later about the debate on the late unlamentedEmployed Persons (Health & Safety) Bill whichsought among other things to reorganize theAppointed Factory Doctor Service.

It seems clear that with all their faults the certify-ing surgeons made a significant contribution to thewelfare of the children of the 19th century. The prob-lems of the 20th century are not those of ill-healthand malnutrition. They are in many ways more

difficult and more insidious, and other agencies are

at work in their amelioration. Nevertheless, underpresent legislation, the appointed factory doctor isthe only medical man who by statute sees the youngpeople during the transition period from school tofactory. Sometimes they are interviewed by theyouth employment services, often they join youthclubs, not infrequently they come under the care ofprobation officers, and all too seldom (although thenumber is growing) they come under the influence ofteachers in further education colleges. MargotJeffreys42 points out in her final chapter that the

needs are complicated and varied, that they cannot bedealt with in isolation and that their interactionrequires a unified approach. Is it not time that we soarranged our affairs that the youth of our countryinstead of being dealt with in a haphazard way werecared for by a single coordinated agency in which theappointed factory doctor would play an effectivepart ?

I wish to thank Dr. T. A. Lloyd Davies, Senior MedicalInspector of Factories, for drawing my attention to therelevant documents in the Public Record Office, and MissJessie B. Webster, M.A., F.S.A. Scot., A.L.A., of theQueen's University Library, for her invaluable assistancein checking the references.Without the forbearance of my secretary, Mrs

Dorothy E. Macartney, this lecture would not have beenprepared for publication and I am grateful for hercooperation.

References

1Brit. med. J., (1925). 1, 46.2Ibid. (1926). 2, 853.'Ibid. (1940). 2, Suppl. p. 62."Hutchins, B. L., and Harrison, A. (1907). History of

Factory Legislation, 2nd ed., pp. 1-2. King, Westminster.5D'Arcy, C. F. (1934). The Adventures of a Bishop, p. 39.

Hodder & Stoughton, London.'Meiklejohn, A. (1959). Industrial health-Meeting the

challenge. Brit. J. industr. Med., 16, 1-10.742 George III C73 Sec 10.'Stuart, J. A. Public Record Office O.S. 2864.9Bain, Alex. Public Record Office O.S. 2864.°0Home Office (Under Secretary). Public Record Office O.S.

2864."Horner, Leonard. Public Record Office O.S. 2844.12W.H.O. Constitution. 1946. p. 3. Geneva."Hind, John. Evidence taken by Mr. Mackintosh for

Royal Commission 1833 on Employment of Children inFactories, p. 89.

4Stuart, J. A. Report of evidence taken for Royal Com-mission 1833 on employment of Children in Factories,pp. 89-93 and p. 127.

"Mackintosh, R. Report of Commissioners 1833 on Employ-ment of Children in Factories, p. 90.

"Martin, John. Evidence taken by Mr. J. A. Stuart forRoyal Commission 1833 on Employment of Children inFactories, pp. 127-133.

7Reade, Richard. Evidence to Royal Commission 1833 on

Employment of Children in Factories, p. 133."Gribbon, H. D. (1969). The History of Water Power in

Ulster, p. 188. David & Charles, Newton Abbot."Rimmer, W. G. (1960). Marshalls of Leeds, Flax-Spinners

1788-1886, p. 131. University Press, Cambridge."°Blackwood's Edinburgh Magazine (1836). No. 249, Vol. 40,

The cotton manufacture, and the factory system (pp. 100-121).

"'Oastler, R. (1836). The Factory Question and the FactoryAgitation. Henry Hetherington, London.

"2Martin T. (1842). 1st Report of Commissioners on Employ-ment of Children in Mines, pp. 23-24.

"'Dictionary of National Biography. (1891). Vol. 27, London,pp. 371-372. Smith Elder, London.

"4Horner, Leonard. 'Factories Regulation Act 1834Explained', sec. 20-21. David Robertson, Glasgow.

"Homer, Leonard. (1836). Factory Inspector's Report,p. 158.

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"IMcLaren, W. S. B. (1888). HO 9792/B4962.""Robinson, George (1853). Public Record Office H045

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OS4771."Howell. (1853). Public Record Office H045 OS4771."9Sykes, T. P. (1891). Manchester Guardian, March 9.4"Correspondence from Smethwick. Public Record Office

H045 B1136/75.4IThe Economist, undated cutting, Public Record OfficeHO B1136/64.

42Jefferys, Margot (1965). An Anatomy of Social WelfareServices, pp. 299-324. Michael Joseph, London.

Received for publication October 30, 1970.

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