118:. AHAs were matched to local authority boundaries. Each AHA district centred on a district general hospital, with some AHAs multi-district and some single district. Responsibility for public health was also taken from local authorities and given to the secretary of state, who also took on responsibility for school health. In effect, there was also a third lower administrative tier as the work of hospital management was done at district general hospital level.
114:, hospital management committees and boards of governors; family practitioner services under executive councils; and community health services (including health visiting, maternity services, vaccination and ambulance services) under local authorities. These organisations were replaced by one unitary structure of 90 area health authorities (AHAs) answering to 14 regional health authorities (RHAs) and, ultimately, to the
95:, amended Crossman’s 1970 proposals. Under these plans published in July 1971, the upper-tier regional health authorities would also be responsible for general planning and the allocation of resources to the lower-tier area health authorities, as well as the coordination and supervision of the latter’s activities. This two-tier health system was in keeping with the Conservative
68:. It proposed creating about 50 single-tier area boards taking responsibility for all health functions in each local government area. It triggered years of debate about the relationship between the NHS, local authorities, and health and social care. In September 1968, the separate ministries of health and of social care merged to form the
79:
rewrote
Robinson's 1968 proposals, publishing a second green paper. Crossman rejected local authorities managing the health service and instead proposed that area authorities should remain directly under the Department of Health and Social Security. He retained the idea that the number and areas of
121:
The 1973 Act also established several committees. Joint consultative committees were established to advise AHAs and local authorities on the performance of their duties under the Act. The Act also required AHAs to establish
160:, but the RHAs remained. Initially, there were 14 RHAs, but they were reduced in number to 8 in 1994 before being abolished altogether in 1996 and replaced by eight regional offices of the
417:
502:
111:
193:
after consultation with universities associated with the region, bodies representative of the professions and any federation of workers' organisations.
152:
published its report in 1979. It heard complaints that AHAs added an extra and unnecessary tier of management. In 1982, the AHAs were replaced by 192
149:
29:
106:
which came into effect on 1 April 1974. This was the first time the service had been reorganised since it was established in 1948. It ended the
138:
134:
were established to give patients a voice into the system. A Health
Service Ombudsman was established with powers to investigate NHS bodies.
33:
37:
69:
44:
but the RHAs remained. Both the district and regional health authorities were then themselves abolished in 1996 as a result of the
115:
57:
84:, but added regional health councils which could undertake those activities for which the local area boards were too small.
145:
in May that added local government representatives to the new RHAs and increased their proportion on each AHA to a third.
254:"The spatial politics of place and health policy: Exploring Sustainability and Transformation Plans in the English NHS"
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66:
Administrative structure of the medical and related services in
England and Wales
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responsible for general medical services (as well as dental, pharmaceutical and
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36:
was passed for
Scotland. In England, they were responsible to an upper tier of
28:(NHS) administrative organisations set up in England and Wales in 1974 by the
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92:
330:"Has NHS reorganisation saved lives? A CuSum study using 65 years of data"
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40:(RHAs). In 1982, the AHAs were abolished and replaced by 192 smaller
452:"Is "DevoManc" devolution, delegation, or dismantling of the NHS?"
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80:
the proposed new health authorities should match those of the
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16:
Area health authorities in
England and Wales (1974–1982)
287:
206:, which were generally established during the same era
475:"1968-1977 - Rethinking the National Health Service"
328:Lale, Alice S; Temple, Jonathan MF (January 2016).
110:of separate provision of hospital services under
102:After years of debate, reform was made under the
494:
186:Four members representative of local authorities
91:government of 1970, the new Secretary of State,
150:Royal Commission on the National Health Service
30:National Health Service Reorganisation Act 1973
180:Chairman - appointed by the Secretary of State
503:Defunct National Health Service organisations
183:Fifteen members; sixteen in teaching areas.
99:for a two-tier system of local government.
327:
353:
334:Journal of the Royal Society of Medicine
252:Hammond, J.; et al. (August 2017).
70:Department of Health and Social Security
454:. No. 352. British Medical Journal
443:
251:
223:
176:Membership of area health authorities:
495:
449:
116:Secretary of State for Social Services
56:In July 1968, the Minister of Health,
419:Royal Commission on the NHS Chapter 4
13:
472:
14:
514:
477:. National Health Service History
226:The Health Services Since the War
450:Godlee, Fiona (22 March 2016).
273:10.1016/j.socscimed.2017.08.007
137:The incoming Labour government
466:
410:
321:
217:
124:family practitioner committees
87:Following the election of the
82:proposed new local authorities
1:
391:"NHS Reorganisation Act 1973"
210:
171:
7:
261:Social Science and Medicine
197:
166:Health Authorities Act 1995
154:district health authorities
104:NHS Reorganisation Act 1973
46:Health Authorities Act 1995
42:district health authorities
38:regional health authorities
10:
519:
51:
224:Webster, Charles (1996).
191:regional health authority
346:10.1177/0141076815608853
204:Health regions of Canada
189:Others appointed by the
158:Health Services Act 1980
132:Community health council
112:regional hospital boards
26:National Health Service
22:Area health authorities
108:1948 tripartite system
97:government's proposals
396:The Health Foundation
302:"NHS reform timeline"
228:. HMSO. p. 538.
141:published a paper on
143:Democracy in the NHS
34:Separate legislation
422:. HMSO. July 1979.
164:as a result of the
473:Rivett, Geoffrey.
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77:Richard Crossman
58:Kenneth Robinson
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24:(AHAs) were 90
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307:Nuffield Trust
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60:, published a
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235:0-11-630963-6
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479:. Retrieved
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456:. Retrieved
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433:. Retrieved
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400:. Retrieved
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340:(1): 18–26.
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311:. Retrieved
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93:Keith Joseph
89:Conservative
86:
74:
65:
55:
21:
20:
18:
267:: 217–226.
130:services).
62:green paper
429:0101761503
211:References
172:Membership
156:under the
128:ophthalmic
75:In 1970,
497:Category
481:18 April
364:26432817
281:28866475
198:See also
458:3 April
402:29 July
355:4724772
313:29 July
139:of 1974
52:History
435:19 May
426:
362:
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279:
232:
257:(PDF)
483:2014
460:2016
437:2015
424:ISBN
404:2024
360:PMID
315:2024
277:PMID
230:ISBN
350:PMC
342:doi
338:109
269:doi
265:190
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148:A
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