ABSTRACT
Medical genetics in Britain began at around the same time as the UK National Health Service (NHS) and remains an integral part of it, something that has been valuable in allowing equitable development across the country and avoiding duplication or developments of doubtful value. The first post-war medical geneticists were university funded, but NHS posts, both laboratory and clinical, progressively became the majority as academic funding declined. Governance and training in the field were largely the responsibility of the Royal Colleges and specialist societies, who worked together flexibly and efficiently and oversaw the steady growth of the network of regional centres. While this model has worked well for specialist hospital-based services, the development of medical genetics in primary care and in public health medicine has been slower. Recent years have seen increasing and at times unwise politicisation of both service and policy developments, notably those related to genomic medicine, while devolution of health care for Scotland and Wales has also resulted in unevenness of developments, raising major issues for the future of the field.
