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When the National Health Service was established in 1948, it was divided into three parts.
The personal health services, including ambulances, health visitors, community nursing and midwifery were run by local authorities. General medical services, including general practice, dental and ophthalmic services were the responsibility of the executive councils. Hospitals were placed under the control of regional hospital boards. Within each region hospitals were formed into groups and responsibility for more routine administration was delegated to the hospital group management committee. Teaching hospitals were excluded from this system. They had their own boards of governors who were directly responsible to the Minister of Health. Within each hospital region joint committees were established to facilitate consultation and cooperation between teaching hospitals and the board's hospitals.
In 1974 the regional hospital boards, hospital management committees and most boards of governors were abolished. They were replaced by regional health authorities and area health authorities, which were responsible for the three formerly separate parts of the NHS. In 1982 the area health authorities were in turn abolished. Their powers were transferred to district health authorities.
In 1948 the North West Metropolitan Regional Health Board was formed with responsibility for Bedfordshire, Hertfordshire, north west London, and Spelthorne. The North West Thames Regional Health Authority was formed in 1974 and was responsible for health services in Bedfordshire, Hertfordshire, the London Boroughs of Barnet, Brent, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow, Kensington and Chelsea and the City of Westminster.
This area of operations was similar to but not identical with the former North West Metropolitan Hospital Region, which comprised Bedfordshire, Hertfordshire (except Royston and east Hertfordshire) Middlesex (except Edmonton, Enfield and Tottenham) part of Berkshire (including Windsor and Maidenhead), part of Buckinghamshire (including Beaconsfield, Eton and Slough), the Metropolitan Boroughs of Hampstead, Holborn, Islington, St Marylebone and St Pancras, and the northern parts of the Metropolitan Boroughs of Hammersmith, Kensington, Paddington and Westminster.
In 1994 the North West Thames Regional Health Authority was merged with the North East Thames Regional Health Authority to form the North Thames Regional Health Authority, with responsibility for Essex, Hertfordshire and north London.