DOCUMBIT.gESUNE ED _1 -55 0231\ SE 024 278 TITLE The British National Health Service: Conversations 'with' Sir George B. Godber. INSTITUTION Fogarty International Center-(DHEW/PHS), Bethesda, Md. REPOBT NO NIH-77-1205 PUB DATE 76 NOTE- 167p. AVAILABLE PRCM Superintendent of Documents, U.S. Government' Printing .Officer Washington, D.C. 20402 ,,(Stock Number 017-053-fr00060-4, $1.80) EDRS. PRICE MF-$0.83,HC-$8.69 Plus Postage. DESCRIPTORS Foreign Couneries; *Health Education; Health . Occupations; Health Personnel; Health Progiais; *Health Services; *Medical Education; *Public Health; Public Health Legislation IDENTIFIERS '*Great Britain 'ABSTRACT This booklet was prepared to disseminate knowledge of the British HationalHealth System to provide for improved cooperation between cliniciaa§,'*health scientiStsand health administrators-iu.the United States and the United Kingdom. Included are chapters on: (1) the evolution of the British National Health . system;(2) its present status; (3) general practices; (4) the relationship_between welfare services and health services; (5) consumer, interests;(6), community medicine;(7) health planning;, (8) allocations of resources;(9) profeSsional,,Atutonomy; and (10) manpower (policies. (SL) ( 1' (***********************************ig*********************************** * Reproductions supplied by EDRS are the best that can be made * * from the original document. , * *********************************************************************** A I A A ,Aimeri likImb..._ U S OEPARTNIENTOPHEALTH. EDUtATION &WELFARE. NATIONAL INSTITUTE OF _ EDUCATION -"wale( WAseir iv- THIS DOCUMENT HAS RESICREPRO- DUCED EXACTLY AS REAfilIFEC!,FROM THE PERSON OR ORGAPNW1OWORIGIM ATING IT POINTS OF VIEW OR OPINIONS STATED DO NOT NECESSARILY REPRE- SENT OFFICIAL NATIONAL INSTITUTE OF EDUCATION POSITION OR POLICY Ilk e a I* a dp0 a a THE BRITISH NATIONAL HEALTH , SERVICE Conversations with Sir George E. Godber A Publication of the Geographic Health Studies Progrant John,E: Fogarty International Center ,for Advanced Study in the Health Sciences 1970 4 1 T # U.S. Department off tlealthEducation, and.Welfare Public Health Service National Institutes of Health --DHEW Publication No. (NIH) iii , Other Publications of the Geographic Health Studies Project JOHN E. FPGARTY INTERNATIQNAL CENTER for ADVANCED STUDY IN THE HEALTH SCIENCES SOVIET HEALTH STUDIES Anatomy of East-West CooperationU.S. - U.S.S.R. Public Health Ex- chinge Program, 1958-1967 The Soviet Ftie-Year Plan for Public Health, 1971-1975* Fundamental Principles of Healt4 Legislation of the U.S.S.R.* Soviet Mdical Research Priorities for the Seventies The Soviet Feldsher as a Physician's Assistant Medical Care in the U.S.S.R. Nutrition Research iin the U.S.S.R., 1961-1970' ,. MachineDiagnosis andInformationRetrievalinMedicineinthe , U.S.S.R.* . / Soviet Medicine: A Bibliography of Bibliographies Chronic Effects of Mercury on Organisms* Soviet Biomedical Institutions: A Directory Soviet Personalities in Biomedicine Soviet Research m Pharmacology and Toxicology A Bibliography of Soviet Sources on Medicine and Public Health m the U.S.S.R. Urban Emergency Medical Service of the City of Leningrad . CHINA HEALTH STUDIES Medicine and Public Health in the People's Republic of China Topics of Study Interest in Medicine and Public Health'in the People's Republic of China: Report of a Planning Meeting A Bibliography of Chinese Soces on Medicine and Public Health in the People's Republic of China: 960-1970 Anticancer Agents Recentlyeveloped m the People's Republic of China - A ,Revieve Prevention and Treatment of Common Eve Diseases* .1 Standard Surgical Techniques, Illustrated* Neurology - Psychiatry* China Medicine As We Saw It Chinese Herbal Medicine . Respiratory Research m the People's Republic of China An Economic Analysis of the Cooperative Medical Services m the It People's Republic of China Acupuncture Anesthesia* Acupuncture Anesthesia in the*People's Republictof China Medicine in Chinese Cultures A Barefoot Doctor's Manual* Chinese Personalities in Biomedicine SWEDISH HEALTH STUDIES ' National and Regional Health Planninj in Sweden O BRITISH HEALTH STUDIES : t. ., British National Health Service Complaints Procedures Community Medicine in England and Scotland *Translations of Soviet and of Chinese Documents, producedinCerylimited quantities Y. -, ... iy 4 S ro TABLE OF CONTENTS Preface vii Milo D. Leavitt, Jr., M.D. ... List of Participants in Conversations .., ix c- _ , 1 The Evolution of the National Health Service 1 2 Present Status of the National HealthService 17 3' The Department of Health andSocial ,security and the 411 Local Agencies fl 30 4The Development and Scope'of General Practice 42 .. .: 5 The RelationshipBetween Social Welfare Services and HealtnServices, ; '60 6Consumer Interests; Expressed Throughthe Community Health Councils, the Health ServicesCommission and Other Institutions 73 , '7Community Medicine ancisthe PlanningProcess 86. i . 8, The Allocation of Resources ina National Health Service104 . 9Professional Autonomy, Private Practiceand the National HealthSemice 119 1 I i 10.HealthManpower Policies, Regulationsand Require- ments 133' , ) , -.-Epilogue 151 . Index . 155 l v 5 O PREFACE Ade. The worldwide eradicatioq of disease is a declared major goal; of United States health efforts, and,aid to all nations toward the elimination of hunger, and sickness is an aini that has been officially enunciatet on several occasions. Much progress in these directions has and is being made, and the John E. Fogarty International Center for Advanced Study in the Health Sciences is playing a part in this progress. t, Established as part of the National InstItutet of Health in July 1968-, and, nani'ed iti memory of the "late Congressman John E. Fogarty of Rhode Islarid, the tenter is an Organization envisioned by Mr: Fogaity and Called for in his' address to the Third National Conferenceon WorldHealth iii September 1963, as "a great international center for research in biblogy and medicine dedicated to international cooperation and collaboration in theinterests,Qf the health of mankind."' , , The'-Center serves as the communications pulse for scientific information emanating from abroad and provides American and foreign scientists oppor- V tunitiesto deal with/ complex problems of vital concern to mankind's wellbeing. These Optiortunities and services are inherent in the Center's International Education Prograrp, in its International Fellowship Program, the VisitingProgramfor Foreign/ Scientistsandthe Iitemational Research Fcchange Program which enables American health prqfessionals to .study abroad. ) Many and vaned health-related topics have beeii investigated by the Center's Scholars-in-Residence Program, by a continuing program of conferences and seminars, and by its6-year -old Geographic Health Studies Program. This latter . enterprise has undertaken a series of studies designed to obtain and disseminate comparative tnowledge of the health care systems of other countries. This document is theAird in a series of 'studies which examines the British National Health System; Which was deVeloped alound an advanced medical- . scientific capability. It represents an alternative approach to a health delivery t system, relying, significantly upon regional and local authoritie's to plan and provide the Serfice. Studies of this health system will,thereforepermit access to kno41111.and eAperience beneficial to other'countries seeking to provide the . most of 1 ;ent health care for its people. Additionally, itis hoped that knowledge of medicine in the. United Kingdom will provide a batis for improved cooperation between Clinicians, health scientists and health adminis- trators in the United States and the-United Kingdom. The principal discussant of this document, Sir George E. Godber, conducted "Conversafions" during his appointment as a. :Scholar-in-Residence at the ^ -Fogarty International ciiter. As a former Chief Medical Officer of the ''''--"' Department, of Health and Social Security; Sir George Godber is eminently' qualified to discuss the ';various aspects ior the National Health _Service.. He \ brings an, iiiternational perspective to his observations since he has visited mbst Vf the countries of Europe and is acquainted with patterns of organization of , health services In these countries and in North and South. America and -Australia. _ 6 O 1 Inquines'abouirthis and Other publications of the Geographic Health Studies Program, which are listed elsewhere in this book, should be directed to Dr. Joieph R.- Quinn, Geographic Health Studies Program, Fogarty International Center, National Instilutes Of Health, Bethesda, Maryland 20014. L 'MILO D. LEAVITT, Jr., M.D. Director . Fogarty International Center a r PARTICIPANTS IN CONVERSATIONS SIR GEORGEI\.GODBER LADY NORMA GODBER MILO D. LEAVITT, k., M.D. Director, Fogarty International renter National Institutes of Health Dr. CHRISTA AI.TENSTETTER Dr. WILLIAM HOLLINSHEAD Visiting Research Professor Departinent of the Army - WRAIR Fogarty,International Center' Dr. ABRAHAM HORWITZ Ms. KATHRYN ARNOW Scholar-in-Residence Chief, Progiain Planning Branch Fogarty International Center Office of the Director National Institutes of Health ,Dr. RONALD A. JYDSTRUP , Bureau of Health Manpower Dr. LOIS K. COHEN Division of Medicine Division of Dentistry Health Resources Administration Dr. DONA f. D R. KORST Department of Health, Education, Bureau of H alth Manpower and Welfare Mr. MORTON A. LEBOW Ms. ANNABELL CRANE AssociateAdministratorfor