In 1988, Margaret Thatcher announced a significant review of the NHS as a whole and from this two white papers were published that outlined the introduction of an ‘internal market’ that introduced competition into the NHS and proposed a split between purchasers and providers of care that continues to this day.
As part of the same legislation, in 1990 NHS trusts were introduced under the National Health Service and Community Care Act. The Professional Committee recognised that unless the Tavistock Clinic became a trust itself, it would probably be swallowed by another trust. In such a situation, the best that could be hoped for was that the Tavistock Clinic would become the standard NHS mental health arm of another organisation and would lose its autonomy.
The changes required to become an NHS trust were significant. Historically most of the administrative functions of the Tavistock Clinic, HR, finance and so on, had been provided by their health authorities. In the 1970s the Tavistock Clinic only had one administrator and one training administrator, now they needed to create all the standard administrative functions necessary to function as an independent organisation and with no extra funding to do so.
The first attempt to become a trust was not successful.
In 1994, Rob Hale took over leadership of the Portman again and by that time the situation was serious. It was an era of aggressive takeovers and asset stripping. The Tavistock and Portman Clinics both had properties in prime locations making them targets.
With Rob Hale back at the Portman it became possible to broker a merger between the two organisations, but with them remaining as two separate clinics within one trust, as they prepared their new bid to become an NHS trust.
Later that year, as part of the fourth wave of applications, the clinics became the Tavistock and Portman NHS Trust. Anton Obholzer became Chief Executive of the new trust and Tony Vineall, previously of Unilever, became the Chair of the Trust Board.