The more recent history of the National Health Service, especially the Hospital Service, has been in the nature of a lumbering from one crisis to another. From the moment of its inception it has proved far more costly than estimated and over‐administered, but in the early years, it had great promise and was efficient at ward level, which continued until more recent times. As costs increased and administration grew and grew, much of it serving no useful purpose, there appeared to be a need for reorganisation. In 1974, a three‐tier structure was introduced by the establishment of new area health authorities, the primary object of which was to facilitate — and cheapen — decision making; to give the district bodies and personnel easier access to “management”. It coincided with reorganisation of Local Government, which included the transfer of all the personal health services and abolition of the office of medical officer of health. At the time and in looking back, there was very little need for this and reviewing the progress and advances made in local government, medical officers of health who had advocated the transfer, mainly for reasons of their own status, would have achieved this and more by remainining in the local government service; the majority of health visitors appear to have reached the same conclusion. They constitute a profession within themselves and in truth do not have all that much in common with day‐to‐day nursing. The basic training and nursing qualification is most essential, however. It has been said that a person is only as good a health visitor as she is a nurse.
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