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Reform and administrative weakness

Labour reforms hindered by economic crisis

The 1962 Porritt Committee (set up by medical organisations independent of the Ministry of Health) recommended the assimilation of all health services under a single authority in each natural area of administration. The report indicated that the medical profession supported the unification of the service. Reorganisation under the Labour governments between 1964 and 1970, and again from 1974, at times took place against a backdrop of economic crisis. This greatly hindered Labour in its policy options and its attempts to reverse the Conservative policy of funding the National Health Service (NHS) through increased contributions and service charges. The Labour government abolished prescription charges in 1964 but, following the financial crisis of 1967, was forced to reinstate them, together with an increase in NHS and national insurance contributions.

By 1964 and the Labour election victory, administrative weakness in reorganisation had emerged as the major NHS problem. Nevertheless, the Minister of Health, Kenneth Robinson, resolved to maintain the existing structure. During the 1960s, however, increasing demand for services and significant policy changes, introduced by the Wilson government, intensified the need for administrative reform. The Seebohm Committee, reporting in 1968, threatened to undermine Local Health Authorities by transferring responsibility for social work to local social service departments. In 1966, a Royal Commission on Local Government, which reported in 1969, recommended the creation of new local authority areas grouped into provinces. Although this was not implemented, it made some reorganisation of the NHS appear inevitable.

Harold Wilson began to grapple with administrative reform in 1967, when the Minister for Health, Kenneth Robinson, began an examination of NHS administration. The outcome was a Green Paper, 'Administrative Structure of the Medical and Related Services in England and Wales'. This document recommended the creation of about 50 area boards in a single organisational tier. These would take responsibility for all health functions in each administrative area.