- 1972-1988 (Creation)
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North Yorkshire Area Health Authority was created in 1974 as a consequence of a reorganisation of the National Health Service (NHS) which came into effect on 1 April that year. The intention of the reorganisation was that community health and hospital services should be managed together in a more flexible and integrated system.
Regional hospital boards and hospital management committees were abolished and replaced by 14 regional health authorities (roughly corresponding to the old regional hospital boards) and, under them, 90 area health authorities sharing the same boundaries as the post-1974 reformed local government areas.
The new authorities had far more extensive duties than their predecessors. Not only did they manage hospitals but they also had responsibility for the community health services formerly managed by local authorities. School health and ambulance services were also transferred to them, while local authorities retained responsibility only for environmental health and social services.
Health education and the registration of private hospitals also became part of the duties of the new authorities. Teaching hospitals were integrated into the structure with the creation of area health authorities (teaching).
The old executive councils which had managed family practitioner services were also abolished but they were replaced with relatively independent bodies, the family practitioner committees, which performed the same duties, serving populations equivalent to those in the new areas. Family practitioner services thus remained essentially separate from other health care and hospital services.
While regions and areas were the statutory executive authorities, a smaller tier of management, the district (roughly equivalent to the catchment area of a district general hospital) was also established. Since area health authorities greatly differed in size, smaller ones became single district areas, but large areas might contain up to six districts.
Certain concepts and principles underlay the 1974 reorganisation. There was an elaborate machinery for representation and consultation with local communities, with doctors and with consumer interests. Local authority members were appointed at regional and area levels; districts included representation by local doctors, and there was provision for medical advisory machinery at every level; community health councils were set up in districts to represent local consumers.
Management arrangements were laid down in some detail. The concept of consensus management by management teams was introduced: teams were officers equal in status reaching decision by local agreement and having joint responsibility. Members of teams headed functional hierarchies of officers with principles of accountability upwards and delegation downwards. Officers at area and district level were accountable to the area health authority and at regional level to the regional health authority, although the management teams themselves at the different levels were not in a line relationship with each other.
A new planning system was introduced, using strategic and operational planning, in order to better identify aims and priorities. Services were to be planned to co-ordinate with those of local authorities through statutory joint consultative committees. A more even distribution of resources was aimed at by use of the formula devised by the Resource Allocation Working Party (RAWP) which reported in 1976.
North Yorkshire Area Health Authority was within Yorkshire Regional Health Authority. The Yorkshire region covered North Yorkshire, West Yorkshire and Humberside and included seven areas, all of which coincided with local government boundaries.
The regional health authority was composed of a chairman and between 18 and 24 members, two thirds of which were appointed by the Secretary of State and one third by the local authorities. Members served on a voluntary basis. Some local authority representatives were also included. The regional health authority had responsibility for planning and financial allocations and it also directly provided certain services such as major building schemes and blood transfusions. It was also the employing body for consultants.
Accountable to the regional authority were a number of individual officers who together formed the Regional Team. The team was composed of a regional administrator, a regional treasurer (or finance officer), a regional medical officer (or community physician), a regional nursing officer, and a regional works officer. Each of these was responsible for a functional hierarchy. The regional treasurer controlled financial services. The regional administrator controlled administrative, personnel, management and supply services (in metropolitan areas the regional administrator also controlled ambulances).
Capital projects were overseen by capital project teams. There was also a legal advisor directly accountable to the regional health authority. The regional works officer was responsible for architecture, engineering, and quantity surveying. The regional nursing officer was responsible for nursing, personnel, service planning and capital projects and training and education. The regional medical officer was responsible for service planning, capital building projects, personnel and postgraduate education and information and scientific services. Multi-disciplinary service planning teams were created for medical service planning. There was also a director of the blood transfusion service and a regional pharmaceutical officer, both directly accountable to the regional health authority. Finally, to advise the regional health authority there was a representative professional advisory machinery.
North Yorkshire Area Health Authority had boundaries coinciding with the new county of North Yorkshire. The headquarters of the area was based in York. Within the area were four districts: Northallerton, Scarborough, Harrogate and York.
Members of area health authorities, like regional health authorities, served voluntarily, and authorities averaged between 18 and 24 members. The chairman of the area health authority was appointed by the Secretary of State; some members of the authority were appointed by the local authority, and the rest by the regional health authority. The area was responsible for planning and liaison with local authorities. It managed certain services directly, for example, ambulances, personnel and supplies, and it also appointed the family practitioner committee.
Accountable to the area authority were a number of officers who formed the Area Team. These were the area administrator, the area treasurer (or finance officer), the area nursing officer, and the area medical officer (or community physician). Each of these headed functional hierarchies of other officers.
The area administrator was responsible for administrative services, medical records, personnel and management services, services to the family practitioner committee, supplies and ambulances. He also co-ordinated with an area works officer who was responsible for building and engineering works. The area works officer was accountable directly to the area authority and not through a team member; he was not a member of the team but attended meetings whenever relevant. The area treasurer was responsible for financial services. The area nursing officer was responsible for nursing personnel, training and education, and school health.
The area medical officer was responsible for the planning of community medical services, for doctors in public health, for specialist support services such as child health, care of the elderly, mental disorders and primary care, and for health education. He co-ordinated with an area pharmaceutical officer and an area dental officer, both of whom, like the works officer, were accountable directly to the area authority, and though not members of the team, attended relevant meetings. As at regional level, the area health authority was advised by professional advisory committees.
Area health authorities were abolished in the 1982 NHS restructuring and their duties passed to the new district health authorities. The North Yorkshire Area Health Authority was replaced by the York Health Authority.
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