Reorganization of the National Health Service: Background and Issues in England's Quest for a Comprehensive-Integrated Planning and Delivery System

The first major reorganization of the National Health Service since its founding in 1948 will take place on April 1, 1974. Three major objectives are involved: the consolidation of the tripartite structure into a single unified system, the strengthening of management processes, and the expansion of...

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Bibliographic Details
Published in:Milbank Memorial Fund Quarterly. Health and Society 1973-01, Vol.51 (4), p.489-530
Main Authors: Battistella, Roger M., Chester, Theodore E.
Format: Article
Language:English
Subjects:
Communities
Community Health Services
Community Participation
Costs and Cost Analysis
Decision Making
Delivery of Health Care
Economics, Medical
Education, Medical
General practice
Group Practice
Health care administration
Health Education
Health Facility Planning
Health planning
Hospital planning
Hospitals - utilization
Hospitals, Teaching
Local government
Medical Staff, Hospital
Nurses
Nursing Staff, Hospital
Organization and Administration
Politics
Primary Health Care
Psychiatric hospitals
Public Health Nursing
Regional Health Planning
Social Change
Social services
Specialization
State Medicine
Teaching hospitals
United Kingdom
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Summary:The first major reorganization of the National Health Service since its founding in 1948 will take place on April 1, 1974. Three major objectives are involved: the consolidation of the tripartite structure into a single unified system, the strengthening of management processes, and the expansion of machinery for making health services more responsive to local needs. While generally supportive of the reorganization, this assessment of the changes in policy and structure identifies a number of constraints in the form of political realities and organizational-administrative capabilities which may limit the attainment of objectives. In particular, the bias in modern medicine for hospital-based specialization, the uneven power relationships among competing professional interests, and the continued separation of health from social services are seen as restricting policy aimed at altering the balance between primary, secondary, and tertiary levels of care and between curative and "carative" services.
ISSN:0160-1997
0887-378X
DOI:10.2307/3349631