Report / Royal Commission on the National Health Service.

  • Great Britain. Royal Commission on the National Health Service.
Date:
[1979]
Catalogue details

Licence: Open Government Licence

Credit: Report / Royal Commission on the National Health Service. Source: Wellcome Collection.

    43/510 (page 29)
    deal with general questions relating to the funding of the NHS in Chapter Ze worsening industrial relations — NHS workers at all levels are now prepared to risk the well-being of patients by disrupting or withdrawing services. This has contributed to longer hospital waiting lists and probably lowered morale. We say more about this in Chapter 12; the changing status of the medical profession — the status and influence of doctors has been eroded in recent years. Their authority has been challenged by the rise in influence of other NHS professions, and there has been a narrowing of pay differentials between them and the less well paid workers in the health service. We discuss various matters relating to doctors in Chapters 7 and 14; the position of nurses — nurses have acquired more influence in the management of the NHS partly due to the restructuring of the profession after the Salmon and Mayston Reports’ and partly due to their increased participation in management through reorganisation. We discuss various matters relating to nurses in Chapters 7 and 13; the pay beds argument — the then government’s decision to phase out pay beds from NHS hospitals was announced at a time when hospital consultants were already under pressure. The pay beds issue was also the occasion for industrial action to be taken by ancillary and other workers for motives which were not directly connected with their conditions of service. We deal with pay beds in Chapter 18; local government reorganisation — health and local government reorgani- sation took effect at the same time in England and in Wales and Northern Ireland. In Scotland local government reorganisation occurred roughly a year after health services were reorganised. In Northern Ireland an important innovation was bringing health and personal social services together under the same authorities. We discuss the relationship between the NHS and local authorities in Chapter 16. 4.5 The unification of the three parts of the NHS under single health authorities was generally supported before reorganisation was introduced. There were arguments about the means of achieving it, but the principle of unification was not seriously disputed. Indeed, the desirability of unification had been part of the conventional wisdom for many years. The difficulties of introducing the new arrangements were undoubtedly underestimated, and one important part of it, the NHS planning system, was not launched until two years after the transfer of staff and responsibilities had taken place. One commentator offered us the following advice: “It will probably be at least a decade before its [ie the 1974 reorganisa- ‘Ministry of Health, Scottish Home and Health Department, Report on the Committee on Senior Nursing Staff Structure, London, HMSO, 1966. Department of Health and Social Security, Scottish Home and Health Department and Welsh Office, Report of the Working Party on Management Structure in the Local Authority Nursing Service, London, HMSO, 1969.