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Scattered throughout this report, however, you will find reference
to difficulties experienced in co-ordinating services provided by various
statutory authorities and voluntary bodies with widely different
boundaries and catchment areas and with functions which often
overlap or fail to link up with each other. So far as the health services
are concerned, I think there is much to be said for the functions of the
existing local health and local sanitary authorities, local education
authorities, the hospital management committees and local executive
councils, all being administered by one elected body in one given area.
In order that the services may be controlled locally, the district should
contain a population not exceeding 250,000 and should, if possible,
cover both urban and rural areas. (Unfortunately an impossibility
in the conurbations.) Perhaps I should also make it quite clear that I
am not suggesting that the Medical Officer of Health should necessarily
be the senior administrative officer of such a comprehensive health
authority, indeed, I think there is much to be said for freeing him
for his most important functions—those of epidemiologist and health
educator.
Certain highly specialised hospital services would still have to be
provided on a wider basis and elsewhere I have suggested that likewise
ambulance services should be organised regionally. These and other
lunctions such as Town and Country Planning, Fire and Police services
at present administered by County Councils could well be passed to a
limited number of new Regional authorities—in some cases formed
by a combination of smaller counties.
I realise that proposals of such a nature will not find ready acceptance
involving, as they do, the merger of some smaller authorities
and the transfer back of certain functions from many "major"
authorities. Nothing less than the radical will suffice to strengthen
cur local government system however. Unless it is strengthened and
rejuvenated still more services will inevitably be turned over to specially
seated bodies of centrally appointed, rather than locally elected,
members. Local Government will then cease to attract members and
officers of the same high standards and abilities as hitherto and will
wither away.
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