Legislating for three kingdoms in the early nineteenth century: the case of medical professional regulation

Legislating for three kingdoms in the early nineteenth century: the case of medical professional regulation

Professor Joanna Innes explores the legislative treatment of the three kingdoms from the Acts of Union to the end of the 19th century.

In the early nineteenth century, the Westminster parliament addressed itself, with a sort of experimental determination, to the task of legislating for England and Wales, Scotland and Ireland. At this date England and Wales are almost always bundled together for legislative purposes, so the operative units were the three kingdoms, not the four nations.

From the Act of Union of 1707, the Westminster parliament served Scotland as well as England and Wales. But for most of the eighteenth century, though Scotland was subject to pan-British fiscal legislation, it was rare for its internal governance to be addressed by parliament. This seems to have been partly because London-based ministers were not concerned with most of what went on in Scotland, also because those who might have promoted Scottish legislation hesitated to expose their projects to the uninformed interference of majority-English MPs. Instead, as Lindsay Farmer, Ann Whetstone and others have shown, Scots experimented with new forms of self-governance, through for example courts of law, and county meetings.

This pattern started to change at the end of the eighteenth century, when Scots began to bring more proposals to Westminster. Change was further spurred by union with Ireland from 1801. From 1782 to 1800, during the era of ‘legislative independence’, the Irish parliament had legislated vigorously. Some hoped that Westminster, precisely because it was not dominated by (Anglo)-Irish MPs, would provide a more sympathetic forum for addressing Irish ills. In fact, those hopes were quickly disappointed; moreover, ministers were slow to adjust to the new imperative of legislating for Ireland. Only when Robert Peel became chief secretary from 1812 did the practice of bringing in each session a programme of Irish measures develop. (As in England, Wales and Scotland, backbench MPs also continued to propose bills). At the Home Office in the early 1820s, Peel employed staff specifically charged with modifying legislation to apply to all three kingdoms. Sometimes the same act applied to all three, but more commonly, parallel, differentiated measures were brought in, taking account of each kingdom’s institutional and legal traditions, and what those in a position to shape discussion thought appropriate to its circumstances. The bringing in of distinct Poor Law bills (for England and Wales in 1834, Ireland in 1839 and Scotland in 1845) illustrates the pattern, though parallel measures were usually introduced in quicker succession.

It is sometimes suggested that Ireland served as a laboratory for England (e.g. in relation to new police). However, this oversimplifies. What went on rather was a complex process of borrowing and adaptation, in which initiatives in any of the three kingdoms might provide a template for others, and, though there was copying, it was rarely slavish.

During the early nineteenth century, these processes were under development – and they always remained (as now) subject to critique and revision. But at that time the learning curve was especially steep. Legislating for three kingdoms was more challenging than for one, and some projects capsized as a result. A case in point is the Surgeons’ Bill of 1816-18.

Medical historians have traditionally seen the 1815 Apothecaries Act as inaugurating the modern era in medical professional regulation (Irving Loudon, Medical Care and the General Practitioner 1750-1850, provides the most influential account). The Act reshaped the powers of the London-based Apothecaries Company. Loudon and others have strangely failed to register that this bill was intended to be complemented by a Surgeons Act. Most formally trained medical practitioners were then surgeon-apothecaries. The Apothecaries Act provided a framework for registering that side of their training; a complementary Surgeons Act would have provided a regulatory framework for the other side.

Loudon blamed the elitism of the Royal College of Surgeons for the absence of complementary provision in surgery. But this charge is misplaced. In fact, the Royal College, having been consulted, had agreed to a further bill, which would have reconfigured their role. That bill was brought into parliament in 1816 by the elderly (72-year-old) but very experienced MP George Rose, who took a special interest in medical issues. It was he who had shepherded the Apothecaries Bill through parliament.

This new bill however encountered much more opposition than the previous one, above all, from Scotland and Ireland. For many years, Scottish universities and hospitals had supplied highly regarded medical training; indeed, many English medical practitioners received at least some training in Scotland. There were however long-standing disputes about the status of Scottish medical qualifications. Scottish medical bodies saw the introduction of the Surgeons’ Bill as giving them a chance to weigh in and stake their claim to recognition. Irish medical bodies followed suit.

The government recognised the merits of the arguments. It was perhaps unfortunate that Rose (who had 25 years of official experience) died at this time. But the Solicitor General proposed to take charge of the bill, to remodel it, and bring it back with a UK remit. Yet it was hard to devise a framework to suit the whole of the UK. The Solicitor General did not succeed in convincing the Commons that he had a sufficient grasp of the issues for his bill to make it even to committee stage. No Surgeons Act eventuated, and the legislative medical-regulatory framework remained both lopsided and geographically limited.

It is conceivable that, in the eighteenth century, parliament might have got away with taking a purely English view of the matter. By the early nineteenth century, this was much harder. Although it was only after the case for taking a wider view had been agitated by Scottish and Irish bodies that government and parliament saw the light, in the face of that challenge, they did accede – but then failed to deliver. The limits of Westminster’s ability to legislate for the whole of the UK were illustrated. It would never be easy to produce three-kingdom-wide domestic legislation, but official bodies were even less well equipped for this task at this point than later. Not until 1858 did a comprehensive Medical Act provide a regulatory framework for medical practice across the UK.

Joanna Innes is professor of modern history at the University of Oxford, and a fellow of Somerville College. One strand of her research focuses on the history of social-policy making in England during the eighteenth and early nineteenth centuries: although she focuses on England, she’s long been convinced of the need to set English developments in British and United Kingdom context. Her chapter ‘Legislating for Three Kingdoms’ in Julian Hoppit ed. Parliaments, Nations and Identities in Britain and Ireland 1660-1850 (2003) elaborates on the general background sketched here.

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