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III. Improving Local Health Services

George James, M.D.
JAMA. 1962;181(4):325-327. doi:10.1001/jama.1962.03050300045011.
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MY PURPOSE is to discuss the mission of the National Advisory Committee on Local Health Departments. I should like to ask that 3 general principles be kept in mind:

  • Local health services should be designed solely to meet specific local health needs effectively and efficiently.

  • The rapid change in health needs requires extreme flexibility in the development of local health services.

  • Flexibility is aided by: (a) research efforts to create new resources and package them for greater acceptability to the population; (b) demonstrations to develop and adapt the new resources for practical programs for specific populations; (c) a chronic

feeling of dissatisfaction with all results in order that we be constantly forced to evaluate them and improve their shortcomings; and (d) over-all administrative guidance by one or more public health generalists.

Our cherished traditions, charters, and manuals of procedure are greatly disturbed when we leave our sheltered nooks in the


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