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The 1974 reorganization of the British National Health Service--aims and issues.

Abstract Britain's National Health Service is to undergo a massive restructuring on April 1, 1974, the chief aims of which are to introduce greater managerial efficiency and to promote a better balance among hospital-focused specialists' services for acute treatment, community-based family-practitioner services for primary care, and the care of the long-term chronically ill. The machinery for these changes involves, first of all, the unification of hitherto separate hospital, family practitioner and public-health services into an integrated system, secondly, the participation of clinicians in management and, thirdly, the introduction of multidisciplinary consensus teams for management and planning at operational levels. Notwithstanding a number of shortcomings, the reorganization appears both necessary and timely. The main criticism is that insufficient action has been taken to link up health with social services, so that another major reorganization is inevitable in the foreseeable future. (N Engl J Med ...