3.

The Travancore-Cochin Public Health Act 1955 (Act XVI of

1955);

4. The Madras Public Health Act 1939 (Madras Act III of 1939)

As per the Kerala Panchayat Raj Act, 1994 (Third, Fourand Fifth
Schedules) and the Kerala Municipality Act, 1994 (First Schedule)
public health is a function which has been develoved to local
governments, particularly the Village Panchayats and Municipalities.
Some of the important functions related to public health listed in the
Schedules mentioned above are given below:

(i) Collection and disposal disposal of solid waste and control of liquid
waste disposal;

(ii) Sanitation and maintenance of environmental hygiene;

(iii) Management of markets;

(iv) Vector control;

(v) Regulation of slaughtering of animals and sale of meat, fish and

other perishable food items;

(vi) Regulation of eating establishments;

(vii) Prevention of food adulteration;

(viii) Immunization and other preventive measures;

(ix) Opening and maintenance of burial and burning grounds;

(x) Licensing of dangerous and offensive trades;

(xi) Control of fairs and festivals;

(xii) Providing of toilet facilities in public places;

(xiii) Licensing of pet dogs and destroying stray dogs;

(xiv) Management of dispensaries, primary health centers and sub-

centres, community health centers, taluk hospitals and district
hospitals;

(xv) Management of child welfare centers and maternity homes.

Government have already transferred the management of Primary
Health Centres and Dispensaries to the Village Panchayats, the
Community Health Centres (CHCs) and Taluk Hospitals to the Block
Panchayats and Municipalities as the case may be. A decision has
recently been taken to transfer the District Hospitals to the District
Panchayats. Thus barring a few special purpose hospitals and the
Medical Colleges, the entire health care system in Allopathy, Ayurveda
and Homeopathy have been rought under the control of local
governments.

In Kerala there are two Acts governing public health - The Travancore-
Cochin Public Health Act, 1955 covering the erstwhile Travancore-
Cochin areas and the Madras Public Health Act, 1939 covering the
erstwhile Madras Presidency areas. After independence major policy
changes have been brought about in the sphere of public health. There
have been rapid advancements in technology applications and certain
basic shifts in perception of governmental responsibility in public
health. With the local governments being brought to the center of
public health responsibility there is undoubtedly a need for a unified
Public Health Act. The Committee or Decentralisation of Powers
recommends that a unified Act be brought about which clearly defines
the role of various government institutions, the level of local
government control over them, the duties of medical officers, the
responsibility of various health staff, issues of preventive health care,
sanitation and hygiene including management of waste and control of
pollution. Already a Kerala Public Health Bill has been drafted. The
Committee recommends that this Bill can be used as a base an
improvements made in accordance with the changed context. An
expert committee may look into the Bill and suggest modifications
required.

As the enactment of a fundamental law like the Public Health Act

would take some time, it is suggested that immediate amendments
may be brought about in the two Acts governing public health which
are now in vogue.

1. The Travancore-CochinPublic Health Act, 1955.

The amendments suggested to this Act are listed below:

1) In Section 2 of the Travancore-Cochin Public Health Act, 1955 the

definitions of the terms 'District Councils', 'local authority', 'executive
officer', 'executive authority' may be amended suitably.
2) In Section 3, for the words 'Director of Public Health' the words
'Director of Health Services' may be substituted. Consequential
changes may also be made.

3) In sub-section (1) of section 7, the words 'urban' and 'may and if so

required by the Government' may be deleted.

4) Sub-section (2) of section 7 may be omitted and sub-section (1) of

the said section may be renumbered as section 7. After Section 7 so
renumbered, the following proviso may be added namely:-

"Provided that, where in the area of a Village Panchayat or Municipality

there is no Health Officer posted the Government may nominate a
Medical Officer serving in any of the health institutions under the
control of the Village Panchayat or Municipality, as the case may be to
function as the Health Officer Ex-officio of that Village Panchayat or
Municipality."

5) In Chapter II following Section may also be added after Section 14,

to provide for control of the local authority over the health institutions
transferred to them.

"14A Local Authority to manage health institutions:- (1) The local

authority shall manage health institutions transferred to it by
Government.

(2) The government may issue directions to the local authority on

matters relating to health policy, planning for health facilities,
standards to be maintained, mode of administration and it shall be the
duty of the local authority to carry them out."

6) Chapter III deals with water supply. Section 15 requires the local
authority to provide or arrange to provide water supply to the
inhabitants of the area. The Kerala Panchayat Raj Act, 1994 and Kerala
Municipality Act, 1994 make the supply of drinking water, the function
of Village Panchayat and Muncipality in accordance with the
Constitution Amendments. The Committee has elsewhere suggested
amendments to the Kerala Water Supply and Sewerage Act 1986 to
provide for a clear role to local governments in providing drinking
water. However, Chapter III may be retained as such.

In the light of the recommendation for a unified Public Health Act there
is no need to amend other provisions at present.
2. The Madras Public Health Act, 1939.

The Travancore-Cochin Public Health Act 1955 has been modeled on

the Madras Public Health Act, 1939. Practically the two Acts are almost
identical. The amendments suggested to this Act are listed below.

1. In section 3, the definition of the term "District Control" may be

deleted and the terms "local authority", "executive authority" and
"executive officer" may be redefined.

2. In section 4 and in the subsequent section, the words "Director of

Public Health wherever they occur may be substituted by the words
"Director of Health Services".

3. In sub section (1) of section 9 the words "if so required by the

Government" may be deleted.

4. Sub section (2) of section 9 may be substituted by the following sub

section:

"(2) Where in the area of a Village Panchayat or Municipality there is

no health officer posted, the Government may nominate a Medical
Officer serving in any health institution under the control of the village
panchayat on municipality, as the case may be, to function as the
Health Officer Ex-official of that village panchayat or municipality."

5. After section 16 the following new section may be inserted

"16A Local Authority to manage health institutions:- (1) The local

authority shall manage health institutions transferred to it by
Government.

(2) The government may issue directions to the local authority on

matter relating to health policy, planning for health facilities, standards
to be maintained, mode of administration and it shall be the duty of
the local authority to carry them out."