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Dr Cecil Cook

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Dr Cook seeks to clarify his position

5th September, 1958.

DIRECTOR-GENERAL

On commencing duty here, I suggested that, as I was generally known to have been a Chief State Health Officer, it would be advantageous, if not essential for me in my relations with State Health Departments and the public, to have some form of title or designation identifying my work and authority, and dispelling any suspicion of down-grading.

  1. You agreed that the office of “Director of Public Health” would best serve this purpose and sought the approval of the Public Service Board for this designation. The Public Service Board approved the title “Director of Tropical Medicine” but forbade its use outside the Department. As the designation was required only for outside relationships, I have never used it at all, an omission on which, latterly, appears to have proved unwise.
  2. The recent creation of three offices of “Assistant Director-General” has aggravated the disability under which I labour, as your representative, in my frequent contacts with State Health Authorities, the medical profession and industry. My office must appear to them to be one conspicuous unimportance being undesignated in a Department where Assistant Director-Generals and Directors abound even amongst lay officers and medical officers with much shorter service than myself.
  3. I do not think I am over-estimating the importance of this handicap.  When all is said and done most of the Directors and Assistant Director-Generals administer a code ad formula set out for them. In my relations which State Health Authorities, with the medical profession and with industry, my function is to persuade them, on behalf of the Minister, the Department or the National Health and Medical Research Council, to accept changes in their points of view and in their current practice. I firmly believe that this task is made infinitely more difficult for an officer who lacks official standing, and I am fortified in this view by the frequency with which I am asked, what is my title, how should I be addressed, and what is my office and the stunned look of disillusion or of incredulity which greets my reply.
  4. That my status even in this office has deteriorated was brought to my notice last December when I discovered after nine years service in Canberra that I no longer rated a seniority sufficient to qualify for an invitation to a Christmas function annually held by the Prime Minister.
  5. I believe the time has come for the Commonwealth Department of Health to create a Central Office a Division of Preventive Medicine. Present methods, based as they are on the administration of a code of sanitary rules by a local authority, are out of date. I have only four years left now in the Department and I would be glad of the opportunity to undertake the creation of such a division. In support of the proposal may I advance the following:

(a) The National Health Act prescribes the prevention of disease as a function of this Department.

(b) The prevention of disease today involves the organised co-operation of the medical practitioner and the veterinarian. Neither the local authority nor the Central Health Authority as constituted in the States has the structure of the legal authority to attempt this.

(c) The use of antibiotic, pesticides, hormones in agriculture demand close co-operation between the Health Authority and the Department of Agriculture. This has not been organised at State level and action by the Commonwealth at this stage would contribute to uniformity.

(d) The Commonwealth can most conveniently take the initiative in seeking uniformity in State Laws administered by Health Authorities – Food and Drug Standards, Poison Control, the collection of morbidity statistics, the control of communicable disease and so on. We have made some progress in this direction under a loose sort of Commonwealth-State liaison. Creation of a special division to be devoted to this task would assure stability and continuity of the work.

(e) This is the type of work in which I am currently engaged, and if the office were created I suggest the title “Director, Division of Preventive Medicine” would not be inappropriate.

(C.E. Cook)

5th September, 1958.

DIRECTOR-GENERAL

Recently I discussed with you my dissatisfaction with my position and status in the Department, and you directed me to submit my complaint in writing. I may say that the grounds of discontent are of long standing. My capacity to tolerate them has fluctuated over the years but has recently failed me altogether.

  1. Before assuming duty here in January 1950, I sought and obtained your assurance that my duties would include a general supervision of health administration in the Norther Territory, as affecting the white and coloured population. That you had always intended this is indicated in your correspondence with the Public Service Board before my appointment. In letters dated 8th July, 1949 and the 5th August, 1949, the Board was informed that the appointee would be responsible for the co-ordination of all health problems of the tropical North such as health surveys of aborigines of North and Central Australia, and tropical hygiene problems in North Queensland.
  2. It has become increasingly apparent that staff and administrative re-adjustments in Central Office since have effected, in fact if not in theory, my almost complete exclusion from any effectual contact with Northern Territory staff. In the meantime I presumably remain theoretically responsible for, what I regard as, the low standard of health administration in the Territory.
  3. You will agree that for anyone attempting the supervision of preventive medicine or public health administration in the Territory it would be necessary:
  • to be fully informed upon the incidence of disease, upon measures taken and proposed to be taken, for control.
  • to be fully informed of staff changes contemplated and to have an opportunity at least to discuss these changes where they adversely affect measures of preventive medicine, proposed or actual.
  • to have direct access to and the opportunity of full and free discussion with the Commonwealth Director of Health, Darwin on all matters relating to public health administration. Medical officers in the Territory change frequently and lack experience in practical aspects for the prevention of disease, particularly tropical disease. They require assistance and guidance from Central Office and is neither readily accessible nor easily given under present circumstances.
  • to be in a position to organise and give effect to approved measures of control including those involving the employment of staff and the expenditure of funds.

4. In order to clarify the position, I respectfully request that you direct officers concerned in other aspects of Departmental administration in the Northern Territory, to make the necessary adjustments to accommodate me as an active and effectual medical officer of health in the administrative establishment.

(C. E. COOK)

DIVISION OF PUBLIC HEALTH

A Division of Public Health has been established with the following functions.

Subject to any direction of the Direction of the Director-General of Health:

  1. To study the incidence of disease and the causes of mortality and morbidity in Australia;
  1. To study the factors which are preventable and formulate for the consideration of the Director-General practical measures for dealing with them;
  1. To act as co-ordinating officer with the Public Health Committee and such other committees of the National Health and Medical Research Council as may be determined by the Director-General;
  1. To prepare and bring to the notice of the Chairman of the National Health and Medical Research Council such projects as may be within the province of the Division;

In particular the functions of the Division will be:

(a) To maintain and develop a liaison with the College of General Practitioners in its study of human disease and its control and prevention;

(b) Keep the Director-General informed of any developments in the study of general practice which the Department is sponsoring;

(c) To work through the Public Health Committee, with State and local health authorities and agencies administering laws concerned with the control and prevention of diseases including those related to the purity of food and drugs and the control of poisons, the object being to secure improvement where necessary and reasonable inter-State uniformity is desirable;

(d) To act as a consultant and technical advisor to the Division of Veterinary Hygiene and Plant Quarantine of this Department and its relation to the Department of Agriculture and other agencies concerned in the use of hormones, antibiotics and poisons and other substances under circumstances likely to affect the health of man and impair the value of the drug as a therapeutic agency in man;

(e) To act as a consultant and technical advisor to the Division of Veterinary Hygiene in its study of the zoonoses and their control and to devise and apply measures to prevent human involvement;

(f) To study the activities of the agencies concerned in the medical research relating to preventive medicine, including those established with the Commonwealth Department of Health, and make suggestions to the Director-General for any projects;

(g) To act as a consultant and technical advisor on tropical medicine to the Director-General and keep in touch with the departmental administration in the Central Office with regard to the measures to be adopted for tropical hygiene,

(h) To co-ordinate with the Commonwealth Serum Laboratories and the Public Health Committee any measures practicable to ensure the maximum level of immunisation and to advise the National Health and Medical Research Council on any recommended procedure.

  1. Such other functions as from time-to-time may be allotted by the Director-General.

Doctor C. E. Cook will be the Director of the new Division.

18th September, 1958