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APPENDIX 'B'
OBSERVATIONS ON THE GREEN PAPER
ON THE NATIONAL HEALTH SERVICE
by H.L. SETTLE
The Green Paper follows a decision by the Minister of Health that the present structure of
health service administration is no longer suited to present day requirements and needs to be
radically changed. His proposals envisage the scrapping of the present tripartite administrative
structure — Hospitals, General Practitioner Services and Local Authority Services — and its replacement
by single all purpose area boards responsible for all aspects of the Health Service and each
serving a population of 1 — 2 million. Forty to fifty such boards would be required to England
and Wales.
Under these proposals the London Borough of Bexley would lose its personal and environmental
Health Services and the Health Department would disappear.
The Personal Services which would be transferred include:
Health Visiting
Home Nursing
Domiciliary Midwifery
Maternity and Child Welfare
Mental Health
Care and After Care (Nursing aids, Convalescence, etc.)
Vaccination and Immunisation
Health Education
Family Planning
Etc.,
The Environmental Services to be transferred could include:
Housing
Food and Drugs, and Food Hygiene
Clean Air
Nuisances
Infectious Diseases
Etc.,
(N.B. Paragraph 46 is less positive than paragraphs 24-32 which deal with the personal services.)
I have no doubt that the personal health services I have mentioned could be administered by an
Area Board along with the Hospital and General Practitioner Services. Whether the services would
be as satisfactory for the patient (and let us not forget that he or she is the sole reason for the
existence of the services) as under present arrangements is a matter of opinion.
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