In 1968, clinical and organisational optimism prevailed in the NHS, but the mood progressively receded until, by 1977, various factors had combined to bring the third decade to an unpromising close.
This said, medical progress continued, with advances including the increasingly wide application of endoscopy and the advent of CAT (Computerised Axial Timography) scanning as the service’s investigative armoury was extended.
Transplant surgery was becoming increasingly successful, and genetic engineering slowly began to influence medicine. Intensive care units were now widely available and new drugs appeared, including for example non-steroidal anti-inflammatory treatments.
Kidney dialysis was introduced and surgery established a place in the care of coronary heart disease.
On the downside, new infections, such as Lassa Fever emerged, and changes in abortion law led to new pressures on gynaecological services.
In general practice, the GP's charter was encouraging the formation of primary health care teams, new group practice premises and a rapid increase in the number of health centres.
As the result of the Government's Hospital Plan, new hospitals were providing more people with a better and more local service. The organisation of hospital nursing services was changed by the Salmon Report and nurse education by Briggs, while the advent of information technology saw the first steps in health service computerisation and clinical budgeting.
From 1968 to 1974 debate continued on the crucial question of how the NHS should best be organised. Key issues included local government reorganisation and the desire to improve the co-ordination of health and social services by matching the boundaries of health and local authorities.
What was also needed was a planning system to distribute resources more fairly and to improve management. Two plans fell by the wayside; the third was implemented in 1974, but not until the Government that devised it had been replaced in a General Election.
The new system soon earned criticism as too complex and managerially driven. Within two years, a Royal Commission on the NHS had been appointed to look into the problem areas.
Just as strategic planning, long-range forecasts and reallocation were introduced, inflation reached 26 per cent and wage restraint came in. Industrial action hit the NHS while consultants too were alienated by proposals to reduce private practice within the service.
Excerpt taken from From Cradle to Grave by Geoffrey Rivett. Published by the King’s Fund, 1998. (http://www.kingsfund.org.uk/) ISBN: 1-85717-148-9. Price: £25.00. Available from selected bookshops and the King’s Fund bookshop. Tel: 0171 307 2591.
Photo Credit: Royal College of Nursing, Gerald Pillow