ABSTRACT
In clinical medicine renal transplants had become commonplace in the United Kingdom in the 1960s and Professor Christiaan Barnard had carried out the first heart transplant in South Africa in 1967. The Government had laid down certain criteria for the reorganisation, one of which was that the boundaries of the new National Health Service (NHS) would be 'coterminous' with the reorganised local authority boundaries which would take effect on 1 April 1974. The Sunday Times, under the headline 'Doctors win again', complained that Sir Keith Joseph had produced a sane and logical administrative structure for the NHS, but that left consultants as king. The original intention of the Government had been that the lowest tier of health service management would be the Area Health Authority, but the steering committee persuaded the study group that a lower tier was necessary.
