Re‐forming the NHS

The progenitor of the UK National Health Service, Sir William Beveridge, took as one of his major assumptions — on which he based his proposals for the creation of an NHS — ‘that a comprehensive national health service will ensure that for every citizen there is available whatever medical treatment he requires, in whatever form he requires it, domiciliary, or institutional, general, specialist or consultant……’; he then went on to state that he felt that most of the problems of organisation of such a service fell outside the scope of his report. A somewhat similar cavalier attitude has been evinced towards the creating of an effective organisational structure for the NHS ever since, by successive Ministers responsible for the service, although there have been many attempts to tinker with the system, not least that ill‐conceived decision — based on expensive management consultancy advice — to establish area health authorities. (Equally ill‐conceived and based on pure political expediency at the time, was the linking of the departments of social security and health).