There was a very complex pattern of voluntary and municipal hospitals, but no planning. The insured population – mostly working men – could go to Panel doctors after 1912, but their families were not covered
Doctors were unwilling to join the NHS at first
Local Councils still ran a variety of clinics and services, especially for children.
In 1974 came the first great reorganisation, largely taking local authorities out of the NHS but bringing Community Health Councils in as an alternative patient voice
The rhetoric is always about putting the patient at the centre
2012 was particularly confusing as the new structures overlapped with the old ones
Under Lansley’s proposals the plan was that from 2013 the patient will be in control, the system will be self sustaining and the Secretary of State will fade into the background.
Of course it may not work out like that
