ABSTRACT
The National Health Service was another powerful bureaucracy set up by the Welfare State. Unlike local government, its structure did not even possess the semblance of democratic accountability at community level. Most development decisions were taken on a strategic level, generally governed by technical and managerial objectives. It was to redress the imbalance created by a very centralized structure that Community Health Councils were set up during the 1970s. Lambeth’s CHC proved to be exceptionally vigorous in its role of protector of the community interest. When, in 1975, the NHS proposed the closure of the local hospital, the CHC mounted an energetic local campaign, not to prevent the closure but to put something better in its place. Local residents and health workers (GPs, district nurses and the like) were mobilized into an action group to plan a new type of health facility that would act as bridge between general practice and the large modern hospital.
