In July 1960 Enoch Powell became minister and was shown the five-year plans of the Oxford and Wessex RHBs. He saw that, if all 14 regions had similar plans, they could be brought together and turned into a national scheme that the Treasury might be persuaded to fund.
Powell decided the principles that were appropriate for a plan and applied them consistently, systematically and nationally. RHBs were asked to reassess their needs and submit proposals for the next 10 years. These became the basis of the Hospital Plan laid before parliament on 23rd January 1962. Finance, said the BMJ, might turn out to be the principal obstacle.
The plan proposed the development of 90 new hospitals from scratch, and the upgrading of 134. The minister sent a message to his staff.
The Hospital Plan will determine for many years to come the broad lines of development of the hospital service, and indeed of the health service as a whole. No other nation has had - or taken - the opportunity to refashion its hospitals so comprehensively and on so large a scale.
The Hospital Plan aimed at a network of DGHs of 600-800 beds, normally serving a population of 100,000-150,000. District by district it outlined phased redevelopment over the next decades. The goal was usually the unification of separate hospitals that worked together as a DGH. The waste of consultant time travelling between different hospitals, the difficulty of providing complete training for nurses, the need to bring geriatric and psychiatric services within the curtilage of the DGH and the improvement in clinical care possible on a single site made this desirable. It was also essential to bring ophthalmology, chest medicine, paediatrics, obstetrics, accident services and the long-stay specialties alongside general medicine and surgery.
A new development for the NHS, the costing and the timescales were, as the BMJ thought, optimistic. Nevertheless, the redevelopment show was now on the road.
- For a fuller account of the events, see www.nhshistory.net