The Department replaced an under-funded Board and was charged with preventing deterioration of public health by controlling sanitary works, preventing the pollution of water courses, the adulteration of food and drugs and the sale of unsound food. It controlled local boards of health until their absorption by local government in 1907 and thereafter provided guidance and supervision to local health officers in municipalities. It was not, however, able to enforce action by municipalities until the Public Health Act was amended in 1929. As so often in public health matters, Parliament legislated a solution but not the funds to pay for it. The staff appointed in 1904 comprised the director, a part-time secretary, 3 clerks and 3 caretakers (for the depots maintained as potential quarantine stations or isolation hospitals). Health inspectors were not appointed until 1906. In 1906 the first Medical Officers were also appointed for schools. They were placed on the estimates of the Education Department but had links to the Public Health Department.
On 1 January 1939 these medical inspectors and the school nurses were formally trransferred to the PHD as the School Medical Service. The Department acted as the Tasmanian agent for the Commonwealth Health Laboratory and administered the Commonwealth Quarantine Act until the end of June 1929. (The State Quarantine Act remained in force but was in abeyance due to the division of powers under the federal constitution.) Maternity and child welfare remained largely the province of voluntary associations with limited assistance from the Department prior to WW2.
The Department had a loose internal structure until late 1945 when the Public Service Commissioner made a number of recommendations for the reorganisation of the Public service to prepare for post-War activity. In the case of the Public Health Department this involved the establishment of a divisional structure to replace the existing amorphous groupings such as "inspectors". The Department's inspectors were also inspectors under the Places of Public Entertainment Act and so from 1917 the Department also included the Picture Censor Board until its abolition (some time after 1924). The inspectors were also responsible for factory legislation from 1910 until the establishment of the Industrial Department in 1916 and again between 1930 and 1940. This latter was apparently one of numerous economy measures introduced during the Depression.
Ministerial control in this health area continued to be exercised by the Chief Secretary until 1934 when the first Ministerial portfolio was established for Health.