Introduction

The Seebohm Report recommended the establishment of:

Most of these recommendations were incorporated into the 1970 Local Authority Social Services Act and the new social services departments came into operation in April 1971. These departments were headed by directors of social services whose backgrounds were in the personal social services and who normally possessed some form of social work qualification. Residential homes for elderly people, the home help service, meals and lunch club provision, laundry facilities, aids and adaptations and counselling services were all included in this new department.

A major reorganisation of the NHS was under consideration at the same time, with a focus on the need to reduce the inefficiencies associated with the tripartite structure established by the 1946 Act. (For general accounts of NHS reorganisation, see Brown, 1979 and Levitt and Wall, 1985.) Increasingly, the local authority health services had become seen as “a rag-bag of functions” (Brown, 1979, p 6) that needed to be integrated into the hospital and GP services. The end result of these deliberations was the 1973 Health Service Reorganisation Act, by which Brown has claimed that “basically, the local authority services were nationalised and brought under the same management as hospital services, while the administration of family practitioner services was aligned with the new authorities” (p 22). District nurses and health visitors were no longer to work in a local authority department; they were to be responsible to a district nursing officer who would be a member of a district management team of the health authority. It was the district nursing officer who would have primary responsibility for the allocation of district nursing and health visitor staff; this might or might not involve their location in GP practices. The post of medical officer of health was abolished. Each district management team instead included a community physician whose task was to assess needs and evaluate service provision within the community.