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By the early 1960s it was becoming clear there were many areas of inefficiency within the National Health Service (NHS), particularly where hospitals, clinics and General Practitioners (GPs) were providing the same services. In 1962 the Porritt Committee criticised the tripartite structure of the NHS and recommended that all health services should be assimilated under a single authority in each natural area of administration. This committee was set up by medical organisations independent of the Ministry of Health, and its report indicated that the medical profession supported its suggestions.
In 1964 Labour came to power and began to tackle reorganisation of the National Health Service (NHS). One of its first measures was to reverse the Conservative policy of funding the NHS through national insurance contributions and charges. Prescription charges were abolished, but an economic downturn in 1967 forced Labour leader Harold Wilson to reintroduce them in 1968.
Labour Health Minister, Kenneth Robinson, initially planned to keep the tripartite system. However, in the 1960s official enquiries suggested that reorganising the NHS into regions was inevitable. In 1968 the new Health Minister, Richard Crossman, proposed a system in which 90 local health authorities reported to the Department of Health through Regional Health Councils. These would be independent of local authorities so that government could maintain control over the NHS. In the end, Crossman's plans were not implemented under Labour. Politicians on all sides accepted the basic premise that Crossman had put forward, but politically they felt there was potentially a lot to lose and relatively little to gain from undertaking the huge task of NHS reorganisation.
It was not until the 1970s that National Health Service (NHS) reorganisation took place. In 1970 a new Conservative government came to power with Sir Keith Joseph as Health Minister. Joseph kept many basic elements of Crossman's plans, and in 1974 the changes were established. Area Health Authorities controlled all three parts of the NHS locally, and were answerable to Regional Health Authorities, who were themselves answerable to the Minister of Health.
In 1974 Labour returned to power with Barbara Castle as Health Secretary. She was unhappy with aspects of the Conservative reforms but could do little about it, as there were other political struggles within the National Health Service (NHS) to manage. By the mid 1970s there was an ideological struggle over the treatment of private patients in NHS facilities. In this battle the Health Secretary had very limited success, and only a quarter of pay beds were phased out by 1979. Controversially, it actually led to the growth of the private health system.
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