There Is Nothing New under the Sun!
A well-known feature of growing old is an increasing interest in history and in particular in the lessons that history has to teach us.
At a relatively young age, I formed the view that on most things Socrates, Plato or Aristotle had said it all - the trouble is, of course, that few people have read their works, so this truth is lost on the majority.
But it did not take me very much longer to appreciate that in the field of public health and healthcare, if Hippocrates had not said it already then someone else certainly had, be it Edwin Chadwick or some other worthy.
Which brings me to Lord Dawson of Penn and his benchmark report of 1920 Future Provision of Medical and Allied Services.
There is a view among public health practitioners that 'medical and allied services' have very little to do with health.
There is evidence, however, that the increase in longevity over the past 30 years in developed countries is as much attributable to health care as to other public health measures.
Lord Dawson is probably best remembered for his role as physician to King George V.
To others he will be remembered as the man who invented the concept of publicly-owned health centres, where all the key players in the healthcare team are located under the same roof, so promoting good communications and co-ordinated care.
As a young man I was a beneficiary of this type of care, provided by one of the earliest NHS health centres at Woodberry Down in London.
In the early days of the NHS, as some capital funds were diverted from the massive post-war house building effort, a programme of health centre building was begun.
But this exciting development was soon overtaken by the growth of GP-owned practice premises which shared some, but not all, of the features of Lord Dawson's creation.
So, it is with a feeling of dAje vu that I listen to the current debate about shifting the emphasis away from the hospital to the community and general practice.
We have been here before - or more accurately, Lord Dawson and his colleagues got there first over 80 years ago.
For what Dawson appreciated was the need for an integrated system of care with each part relating to each other.
His complete system comprised four main elements - domiciliary services relating to a primary health centre serving a small town or suburb, which itself related to a secondary health centre in the county or large town which in turn related to a regional centre or teaching hospital. …