| Abstract: | In contrast with current proposals, collaboration with local government was a dominant factor in the 1974 reorganisation of the NHS. Four categories of such collaboration are identified in this paper: the sharing of services; coordination of service delivery; joint planning; and joint prevention. The need for each is discussed in the context of the reorganisation debate and of subsequent events. In essence, the DHSS case for collaboration — and in particular, its emphasis on joint planning — is seen as both a cause of reorganisation and a consequence of the form which that reorganisation eventually took. Emphasis is placed upon the potential role of collaboration as a vehicle for a preventive health strategy and as an important instrument for the development and implementation of major central government policy objectives. Finally prospects for the continuing evolution of joint working are considered in relation to NHS restructuring. It is concluded that the present government's approach to the structure and management of the NHS is likely to undermine its substantive policy objectives especially in the field of community care. |
