Regional Devolution and the National Health Service

Abstract

The history of the regional component in health service organisation is important to any consideration of future developments. The Health Service is composed of elements as far apart as the link of the individual family with an individual general medical practice (and the nurses who work with that general practice) and, on the other hand, some services which are provided only at a national, or at least a supra-regional level. There is a continuum which runs through the district, the regional and the national levels into which an area administration has been inserted, more for its links with other services administered at area level, than because it is an essential component in health service organisation. Some of the relationships are necessary administrative elements and some represent only the kind of scientific or professional link that has to exist throughout a service in which the individual practitioners have to communicate with each other at all levels. The link between the periphery and the most highly developed scientific centres existed quite apart from any administrative organisation of the Health Service, and it will continue whatever the administrative background.