The Politics of Professionalization: MPs, Medical Men, and the 1858 Medical Act

In June and July of 1858, oppressed by one of the hottest summers on record—a summer which, among other things, required parliamentary staff to hang lime-soaked cloths across the riverside windows of the Houses of Parliament to filter out the stench of a 20 per cent concentration of sewage in the Thames—the United Kingdom parliament agreed to the passage of a Medical Act. The Act gave statutory recognition for the first time to a distinct occupational category of “legally qualified Medical Practitioner” “entitled according to his Qualification to practise . . . in any Part of Her Majesty’s Dominions”. It also set up a general medical council with powers to monitor standards of professional training, to register qualified practitioners, and to de-register practitioners found guilty of criminal acts or of “infamous conduct in any professional respect”. The Act fell far short of the hopes of some of its medical promoters, especially those who had campaigned for the criminalization of “quackery”. Yet it was also the first major bill for medical reform to be passed, after sixteen unsuccessful attempts over the previous eighteen years, and it was in large part for that reason that seasoned campaigners for medical reform such as Thomas Wakley were content to argue that half a loaf was better than none. In similar fashion, more recent historians of the nineteenth-century medical profession have been luke-warm in their evaluation of the Act’s significance. They tend to point out all the contextualized ways in which the emergence of a unified profession was destined to happen, with or without legislative encouragement, before grudgingly admitting that, if there is a foundation law of state recognition of the modern British medical profession, then the Act of 1858 is it. In short, the 1858 Medical Act has