H.—3la.

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the impossible. We would advise that the general scheme of health administration requires considerable amendments, and to that end we submit these recommendations : — Head Office. (1.) That the Chief Health Officer have full powers of supervision over all scientific, medical, and sanitary public-health matters within the Dominion. (2.) That anioflicer, to be named the Inspector-General of Health Institutions, be appointed, to have powers of supervision over all public-health institutions. i . That a Chief Sanitary Inspector for the Dominion be appointed who shall be responsible to the Director-General. (4.) That a Business Directory be established at the Head Office of the Health Department, under the charge of an expert business administrative officer to be named the Director of Public Health. (5.) That an educational section be attached to the Business Directory charged with the duty of supplying knowledge and information to the public upon questions relating to public health. Districts. (6.) That from the existing health districts there be created subdistricts. (7.) That Assistant District Health Officers be appointed to be in charge of the subdistricts under the direction of the District Health Officers. (8.) That a Chief Sanitary Inspector be appointed for each health district, with power to instruct the other Sanitary Inspectors within their district; he to be responsible to the Dominion Chief Sanitary Inspector. (9.) That the powers and duties of the officers herein named be clearly defined and the same published. (10.) That all health matters, outside the care of hospital and charitable institutions in town districts and counties, and in boroughs apart from those referred to in the succeeding clause, be placed within the control of the Health Department. (11.) That it be made obligatory on the part of each of the cities and large towns with their contiguous small boroughs and town districts to establish a Municipal Health Department under charge of a Medical Health Officer, and appoint Sanitary Inspectors proportionate to the area and population of the district concerned. The Proper Relations of Local Authorities to the Public Health Department. The proper relations of the local authorities to the Public Health Department, whether in respect to the prevention and suppression of infectious diseases or in relation to public health [generally, appear to have been a matter of doubt for some considerable time. As a general principle, we submit that the two authorities should stand in the relation of associates working together towards common, ends. The Health Department as the authority having a responsibility of caring for the public health throughout the whole Dominion, and being constituted for the purpose of specializing in that direction alone, ought to possess powers of supervision over the acts of all local authorities relating to matters of public health. Whatever local authority is empowered or directed to deal with infectious diseases locally, its administration should be subject to conditions of reporting to, accepting guidance from, and, where neglect might occur, being directed by, the Health Department. The relation should be similar to the relation, of junior to senior partner in a commercial firm. Though full power is given to a local authority in health, matters within its district, the relation of each district to the country as a whole has ever to be borne in mind. The Health Department should, of course, respect the local authorities in the exercise of the powers vested in them, and refrain from issuing directions to any local authority that is actively endeavouring to carry out its responsibilities. We repeat that these separate authorities should regard themselves as partners, and stand not upon their respective rights but upon their common duty to the public, whom they are both called upon to serve. As the relations of the local and general authorities depend upon the general plan of health administration, we submit our ideas upon the subject of a general scheme.