Public health coming home

The article on Public Health ‘Coming Home’ to English local government states that it provides a historical perspective.1 It is, however, limited and fails to address some of the issues that were important in 1974, when it joined the NHS. This letter gives the views of one ‘who was There’ and involved at both central and local level. Bevan is said to have favoured the future NHS to be based outside local government on ‘grounds of efficiency and quality’. But there was another reason. Most of the medical profession were opposed to governance by local authorities (LA), in particular those working in the voluntary hospital sector. Bevan was anxious to retain their willingness to serve in an NHS. There were some very innovative LA Health departments, such as those developing health centres and co-ordinated working with general practice.2 There were some outstanding public health practitioners, identified by Sir George Godber, the Chief Medical Officer at the time,3,4 but these were exceptions. In Counties, PH practitioners were usually treated as professionals, in urban authorities they were more likely to …