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13
nursing is very real and accordingly also annexed to these
prefatory remarks is a paper (Appendix 'B') delivered at a
meeting of the Royal Society of Health specially convened in
July to consider the Hunter Report referred to in the succeeding
paragraph.
Change has dominated the scene in 1972 in breath-taking
manner. In August the long awaited White Paper on the
Reorganisation of the National Health Service in England was
published proposing within a national, regional and area framework
to achieve the aims of integration; co-ordination within and
without the N.H.S.; planning in relation to need no matter where
services are provided; more effective professional participation
in operation and planning; more uniform standards of care;
opportunities for rapid implementation of improvements; flexible,
clear career structures; and effective education and training.
Preceded in the spring by the Report of the Working Party on
Medical Administrators under the chairmanship of Dr.R.B.Hunter
outlining the contribution of the new specialty of community
medicine and of the training and career structure required to meet
demands at regional, area and district level - the White Paper
was quickly followed in the autumn by the publication of the
study commissioned by the Secretary of State for Social Services
of the Management Arrangements considered desirable for the
Reorganised National Health Service. These arrangements
embraced six key features, namely, integration on a district
basis (the district comprising the population served by
community health services supported by the specialist services
of a district general hospital); participation by clinicians
whilst retaining clinical autonomy; co-ordination of the planning
and operation of health services by multidisciplinary teams;
clear allocation of authority and accountability; decentralization
of services balanced by strategic direction; and, last but not
least, the recognition of the need for flexibility of approach in
view of the variety in size of both Areas and Regions. By the
end of the year the National Health Service Reorganisation Bill
was well launched on its Parliamentary journey and, having
given special consideration to the problems presented by
Greater London, the Secretary of State had announced that one
of the sixteen area health authorities to be created within the
Metropolis would serve the populations of the three London
Boroughs of Merton, Sutton and Wandsworth. The first meeting of
the Joint Liaison Committee, designed to pave the way for this
particular area health authority and on which all interested
parties would be represented, was scheduled to take place in
the first week of 1973.