etary of
state, those which relate to the suppression of nuisances have to be
confirmed by the Local Government Board. Such confirmation, however,
though necessary to enable the council to enforce them, does not
itself confer upon them any validity in point of law.

Medical officers.

The county council have power to appoint and pay one or more medical
officers of health, who are not to hold any other appointment or
engage in private practice without the express written consent of the
council. The council may make arrangements whereby any district
council or councils may have the services of the county medical
officer on payment of a contribution towards his salary, and while
such arrangement is in force the duty of the district council to
appoint a medical officer is to be deemed to have been satisfied.
Every medical officer, whether of a county or district, must now be
legally qualified for the practice of medicine, surgery and midwifery.
Besides this, in the case of a county, or of any district or
combination of districts of which the population exceeds 50,000, the
medical officer must also have a diploma in public health, unless he
has during the three consecutive years before 1892 been medical
officer of a district or combination having a population of more than
20,000, or has before the passing of the act been for three years a
medical officer or inspector of the Local Government Board.

Alterations of local areas.

The only other powers and duties of a county council arising under the
Local Government Act itself which it is necessary to notice are those
relating to alterations of local areas. It may be convenient here to
state that certain alterations of areas can only be effected through
the medium of the Local Government Board after local inquiry. These
cases include the alteration of the boundary of any county or borough,
the union of a county borough with a county, the union of any counties
or boroughs or the division of any county, the making of a borough
into a county borough. In these cases the order of the Local
Government Board is provisional only, and must be confirmed by
parliament. The powers of a county council to make orders for the
alteration of local areas are as follows: When a county council is
satisfied that a prima facie case is made out as respects any county
district not a borough, or as respects any parish