The Porritt Review

The Medical Services Review Committee, led by Sir Arthur Porritt, was appointed in 1958 to review the NHS's first 10 years and make recommendations.

It was not government-inspired but organised and supported by all the major medical bodies of the time, including the medical royal colleges and the British Medical Association (BMA). Porritt was president of the Royal College of Surgeons and the BMA. A surgeon of the old school, he began as a sceptic but became convinced that the NHS had to continue and be improved.

The Porritt Committee agreed that the concept of a comprehensive national health service was sound, but suggested that the tripartite system comprising hospital services, general practitioners and community health services was too sharply divided. This division had made the integration of services difficult and resulted in the isolation of doctors.

The committee suggested that the separate allocation of funding from central and local government had contributed to fragmented policies that had compromised efficiency and contributed to a 'loss of economy'. Recommendations made by the committee generally emphasised the need for general medical practitioners to have a greater role in planning of local services.

The committee recommended that area health boards (AHBs) should be established based on general hospital areas and that the AHBs should bring together all aspects of the tripartite NHS system.

During a House of Lords debate on 7 March 1963, Lord Amrulee criticised the recommendation as being impractical to implement, as it would lead to a reconfiguration of the local government system and might overemphasise the relative importance of hospital services, as opposed to preventative services.

The report also noted a change in the role of the state in health services:

'Medicine is no longer solely a partnership between doctor and patient. Three parties are now concerned - patient, doctor, and the state.'