Health services and the public health

摘要

The first person who can be recognised as fulfilling the role of Chief Medical Officer (CMO) was Sir John Simon. He made a great contribution to public health reform in the 19th century. It is ironic that one of the reasons for him resigning from the post was the proposal to transfer it to the Local Government Board thereby placing it under the parsimonious control of the Poor Law Director. The latter was responsible for providing the only state medical services for those unable to pay for private medical care. The provision of these medical services was based on the principle of "lesser eligibility", that is, the service provided was no better than, or at least as bad as, the worst that could be obtained by a private patient. It was this principle that Simon stood out against.