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82
It was the intention of the National Health Service Act to
develop co-ordination of all medical services, i.e. the hospitals, the
general medical and pharmaceutical services and those provided
by local authorities. This was to be achieved by means of the
"health centre" which was to become the focal point but, due to a
number of factors such as financial stringency, insufficient building
capacity in a time of intensive housing activity and a large body of
"doubtful" general practitioners, the first purpose-designed health
centre was not established until 1952. Progress is still very limited
and this tardiness was unexpectedly condoned in 1956 by the
Guillebaud Committee's comment to the effect that equivalent
benefits could be gained by co-ordinating group practices with
local authority clinics and more extensive use of the latter's
premises for such purposes.
With the present demand for combined community care, the role
of the local authority in health matters is rapidly changing and
instead of providing "laid down" stereotyped services there is this
move towards the more flexible, interdependent and specialised
kinds. However, difficulties inherent in forecasting future local
authority functions are not eased by the apprehension with which
the Seebohm Committee's Report is awaited for it is expected that
a great deal of re-organisation and reshaping of systems and ideas
will be recommended.
If this proves to be the case and the recommendations are
implemented, then it is to be hoped that the previous failure to
anticipate increased expenditure commensurate with the growth of
the National Health Service will not be repeated to condemn the
new organisation to a "hand-to-mouth" existence and so reduce its
potential effectiveness to the community.
New Legislation
Two major pieces of legislation were enacted during the current
year which are certain to have some repercussions on a local
authority's personal health and welfare services and some indication
of their purport follows.
National Health Service (Family Planning) Act, 1967
Receiving the Royal Assent and becoming operative on 28th
June of the current year, this Act seeks, with Ministry approval, to
extend local authority powers to make arrangements for the giving
of advice on contraception to include social cases, to provide for
the medical examination of persons for the purpose of determining
what advice shall be proffered and to supply contraceptive substances
and appliances. Although no charge is to be made in
medical cases, nor for advice or examination only in non-medical