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On the reorganisation of the National Health Service in April 1974 responsibility for St Thomas' Hospital and the other hospitals within St Thomas' Hospital Group (Grosvenor Hospital, Lambeth Hospital, Royal Eye Hospital, Royal Waterloo Hospital and South Western Hospital) passed to Lambeth, Southwark and Lewisham Area Health Authority (Teaching). This divided its area of responsibility into districts, of which St Thomas' Health District (Teaching) formed the north-western part. The new health authorities were responsible for community health services as well as for hospitals. In June 1975 St Thomas Health District also acquired responsibility for Tooting Bec Hospital.
A major development during the next few years was the opening of the new North Wing of St Thomas' Hospital in 1976 and the consequent closure of the Grosvenor, Lambeth and Royal Waterloo Hospitals. The Royal Eye Hospital closed in 1980. Its premises became the headquarters of Lambeth, Southwark and Lewisham Area Health Authority.
A further reorganisation of the National Health Service in April 1982 abolished the area health authorities. Their responsibilities were transferred to the health districts. St Thomas' Health District (Teaching) became West Lambeth Health Authority dealing with the same geographical area and the same hospitals with the addition of St John's Hospital for Diseases of the Skin.