To understand advocacy properly – or any other new development in public policy – we should first ask: where did it come from, who created it and what were they trying to achieve? These are historical questions and some readers, who share Henry Ford's view that “history is bunk”, may prefer to skip to Chapter Three in which we start explaining what advocates do. Others, realising that advocates help people to speak with greater confidence to power, may want to think more carefully first about the workings of power in our society. That is what this chapter is about. I start with a story from nearly a hundred years ago.

Rule of the gentry

Soon after the First World War a young doctor who had just completed his training to be a Medical Officer of Health (MHO) applied for his first job – to be MOH for a rural district in Kent. Called for interview, he was asked one question only: “Do you hunt?” It happened that he could answer “Yes” to that question and he was promptly appointed. (He told me all this 25 years later.)

Months later, young Dr Metcalfe Brown decided he had to close down the local all-age school, which was plainly unsafe for human use. He was summoned at once to the Hall – home of the local lord of the manor – where the man himself, who was also chairman of his Public Health Committee, boomed at him as he approached: “We only appointed you because you said you would hunt. You’ve never been with the hounds. And now you want to close my school!” And it was, in a sense, “his” school because, long before, his family had built it.

This must have been a moment when a junior medical officer gratefully recalled that the Victorian legislators who created his service had foreseen this kind of situation. They wrote into their law that those holding the post of Medical Officer of Health could only be sacked with the approval of the Minister in London. Their work would inevitably bring them into conflict from time to time with local landlords, industrialists and other powerful people. No other public official had this protection. It made the MOH the senior local government officer, after the Town Clerk who was the lawyer we would now probably call Chief Executive.