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History of the Department

  • Last modified date:
    23 May 2007
Paramedic helping older woman into ambulance

Healthcare services have been the responsibility of central Government for more than 50 years. The Department has made many changes throughout its history to support the public to lead healthy lives.

Establishing a health department

Free medical treatment for everyone in England was first proposed in 1942

The Ministry of Health was established in 1919 to bring together the medical and public health functions of central government, and co-ordinate and supervise local health services in England and Wales. It made improvements in areas such as adoption, tackling smoking, housing, public health, food and medicines, as well as offering advice to voluntary hospitals, which provided most of the medical training at the time.

The Ministry made its first steps towards a better organised health care system when it published its first White Paper in 1928. The co-ordinated emergency hospital service set up during World War II, further provided a blueprint for the National Health Service.

The right to medical treatment for everyone under a new national health service was first proposed in 1942 as part of the Social Insurance and Allied Services report. These proposals were followed by the publication of the National Health Service Act in 1946.

The creation of the National Health Service

Mother with baby at local GP surgery
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The NHS was founded on 5 July 1948, bringing together hospitals, GPs, opticians, dentists and other services into an integrated and organised healthcare service for the whole population.

The following decade saw the introduction of patient prescription and standard dental treatment charges, as well as the publication of the Guillebaud Committee Report in 1953, which called for better information and analytical services to resolve financial difficulties in the NHS.

Major developments in the 1990s included the introduction of the NHS Chief Executive post, and the publication of the White Paper, The New NHS: Modern, Dependable, which set out a new approach for the NHS based on partnership and performance.

The NHS marked the turn of the millennium with the publication of The NHS Plan in 2000, setting out a 10 year modernisation programme of investment and reform. The NHS Improvement Plan followed in 2004.

The 2005 Your health, your care, your say listening events asked the the public, service users, and professionals how local NHS services could be improved. These views helped shape the policies within the 2006 White Paper, Our health, our care, our say: a new direction for community services.

Improving public health

Scene from 2006 Smokefree England campaign advertisement
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A founding principle of the NHS was that it should improve health and prevent disease, and not just provide treatment for those who are ill.

Much of the Department's work on public health has been shaped through the publication of White Papers, health education initiatives and advertising campaigns.

The Health Education Council and the Department of Health and Social Security began to launch national campaigns in the late 1960s. Landmark campaigns have included the first no smoking campaign in 1974 and the first AIDS and HIV awareness campaign in 1986.

Three White Papers, published between 1977 and 2004, represent the Department’s ongoing commitment to public health. The White Paper, Prevention and Health, led to a single focus for the Department on preventative work. The 1991 White Paper, Health of the Nation, identified coronary heart disease (CHD), cancer, mental health, AIDS, HIV and sexual health, and accidents as five key areas for improvement. The White Paper, Choosing Health, outlined the Department’s strategies for improving public health and tackling health inequalities in the 21st century England.

Improving social services

Young boys playing on climbing frame
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Since the 1960s, the Department has ensured that England’s social services offer a range of support to protect vulnerable children and help adults to carry on in their daily lives.

In 1965, the Seebohm Committee reviewed the provision of personal social services in England, and published a report in 1968 on Local Authority and Allied Personal Social Services. The report recommended the creation of local authority departments to manage social services and provide professionally trained generic social workers.

The Department of Health created the Social Services Inspectorate (SSI) in 1985 to improve quality and set standards for personal social services. The SSI was replaced in 2004 by the Commission for Social Care Inspection (CSCI), an independent body that works alongside the Department.

Landmarks in social care legislation have included the Mental Health Act 1983, which has helped improve the care of detained patients, and the Children Act 1989’s framework for making children's welfare a health policy priority.

In recent years, The White Paper, Our health, our care, our say: a new direction for community services, set out ways to provide improved social services in local communities.

How the Department has changed

Staff members talking in office
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Throughout its history, the Department has evolved to make it better equipped to lead the health and social care system.

This process has involved taking on new areas of responsibility, and transferring parts of the Department to other departments or new bodies that are better placed to provide effective leadership and services.

The first major organisation took place in 1968 when the Ministry of Health merged with the Ministry of Social Security to form the Department of Health and Social Security. The Department underwent further restructuring in 1974, following the National Health Service's own reorganisation.

The Department split again in 1988 to form the Department of Health and the Department of Social Security. It then began to devolve power to newly created arm's length bodies in 1989, with the creation of the Medicines Control Agency.

The most recent change programme took place in 2003, leading to a smaller Department with six ministers, 2,245 staff and three executive agencies.

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