New demands on nursing

Although the architects of the National Health Service had envisaged a comprehensive and unified service, it was in fact a conglomerate of sectarian interests and a compromise between competing demands. The service was rather like three old houses that have been joined together but have kept their dividing walls, whose inhabitants only communicate with one another through the distant landlord. The strain on the structure was made worse by the new demands for care and the fact that the services were unequally distributed, for the mortality and morbidity patterns were the same as in Chadwick’s day, ¹ and the health service made no provision for their redistribution. The other problem was that it was an ‘illness’ service with the most prestigious part of the building occupied by the hospital services whose mechanistic philosophy dominated all policy and expenditure.