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4 May 1979

Margaret Thatcher becomes Prime Minister

Margaret Thatcher becomes Prime Minister, following an election manifesto suggesting the government would simplify and decentralise the health service to cut back bureaucracy.

8 July 1979

Merrison report

The Royal Commission on the National Health Service, chaired by Sir Alec Merrison, aimed to consider the best use and management of the financial and human resources in the NHS.


Encouragement of the privatisation of ancillary services

The government started to encourage the privatisation of ancillary services such as cleaning and laundry by sending a letter to health authorities encouraging them to tender contracts.

8 August 1980

Health Services Act 1980

Legislation provided for structural reorganisation of the NHS, enabling the Secretary of State to establish district health authorities (DHAs).

10 March 1981

Tax breaks for employers offering private insurance benefits

The 1981 budget statement committed to removing tax on medical insurance premiums paid by employers for the benefit of staff earning under £8,500 a year.

1 April 1982

District health authorities (DHAs)

Following the Health Services Act 1980, the NHS (constitution of district health authorities) order created 192 DHAs to replace area health authorities (AHAs).

Autumn 1982

Thatcher Cabinet's private consideration of radical reform of the NHS

As the prime minister offered public reassurance that the NHS was safe, the Cabinet considered introducing private health insurance and increasing user charges.

6 October 1983

Griffiths report on management in the NHS

The report of the NHS management inquiry team, led by Sir Roy Griffiths, resulted in the introduction of general management in the NHS.


Academics' development of the idea of GP fundholding

Academics and system leaders discussed the possibility of a primary health care unit being the budget holder for primary and secondary care.