The History of the CHA

The Community Hospitals Association was founded in December 1969. The spark, which fired its founding, came from Bishopsteignton in Devon where Dr Michael Tuck, a local GP, had become frustrated by fruitless attempts to obtain reasonable remuneration for casualty work. Following a letter to the BMJ he arranged a meeting in Exeter and the Association of General Practitioner Hospitals was created. This clumsy title was chosen to avoid using the term 'cottage', which can have Victorian connotations. The introduction of 'Community' was discussed but considered to be too abstruse.

Rather than simply pursue remuneration, the aim of the Association was stated as the retention and development of GP Hospitals as an integral part of the NHS. The majority of these units were very much under the threat of closure foretold by the hospital plan of 1962 which pressed for the concentration of resources into hospitals of 300 beds or more.

Of the 2800 hospitals in England and Wales over 1000 were listed for closure, but many of these were small specialist units whose absorption into the main body of the District General Hospital was a rational and generally desirable move. The closure of local hospitals staffed by GPs, however, was an entirely different matter.

The Association began as a pressure group, and soon set about gathering information upon which is arguments were to be sustained. The chairman (and his successors) toured the country visiting GP hospitals. Two essential features soon became apparent - that as a group they should be looked upon as an extension of General Practice, and that in particular each was unique. No two hospitals were alike in size or function.

In 1974 the Oxford Regional Hospital Board, realising the impossibility of catering for a largely rural population with District General Hospitals alone came up with proposals for the establishment of Community Hospitals, using the newly-designed unit at Wallingford as its model.

Meantime the number of closures had remained small and the Cottage/Community Hospitals of Britain were gathering strength and enthusiasm. Despite common belief there are still, in Great Britain over 470 Community Hospitals.

The classic study made by the Association's second Chairman, Dr Sandy Cavenagh of Brecon, in 1977, revealed that over half the patients treated in General Hospital beds could be cared for equally well or better in a small hospital near their homes.

The gathering of accurate information has been bugged by problems of definition, made more difficult recently by the trend for small specialist units to adopt the term 'Community'.

The wide range of activities encompassed by today's Community Hospitals provide evidence that they have a unique ability to adapt to local demands and conditions.

Dr Meyrick Emrys-Roberts
Founding President.