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      Summary of Organizational Changes in USPHS
Affecting Roles of Assistant Secretary for Health and Surgeon General

Surgeon General.  A post created by order of President John Adams in 1797.
The early Surgeons General served many years and the Office gathered
prestige and credibility.

Assistant Secretary.  When the Department was created in 1953, a special,
non-career position of Assistant for Health and Scientific Affairs was
established in the Office of the Secretary.  This was a staff position and
did not directly infringe on the responsibilities of the Surgeon General as
the head of an operating agency who reported directly to the Secretary.
However,  over time, many of the high-level negotiations on politically
sensitive issues came to be handled by this Assistant, and the Secretary
often turned to him for advice on key health policy matters.  In 1965,
this position was given the title Assistant Secretary, while retaining its
staff character.  The incumbent, Dr. Philip Lee, exercised an increasingly
influential policy role in the following two years.

1966 Reorganization.  Reorganization Plan Number 3, approved in 1966,
abolished the four-bureau organization of the Public Health Service, which
had been established in 1944, and placed all of the Surgeon General's
statutory authority in the hands of the Secretary.  The Secretary redelegated
this authority to the Surgeon General.

1968 Reorganization.  In 1968, under authority of Reorganization Plan Number 3,
the Secretary gave the Assistant Secretary for Health and Scientific Affairs
line authority over the Surgeon General.  The formal delegation of authority
now went from the Secretary to the Assistant Secretary, who then redelegated
it to the Surgeon General.  A few weeks later, however, a new order was issued
abolishing the status of the Public Health Service as an operating agency
managed under the direction of the Surgeon General.   It established instead
three separate health agencies, the heads of which reported directly to the
Assistant Secretary.  The Surgeon General became the "principal Deputy" to
the Assistant Secretary but without line authority, except in the absence of
the Assistant Secretary.

A variety of configurations regarding the Assistant Secretary for Health and
Surgeon General have been in operation since 1968 with specific delegations
varying according to the organization structure and wishes of the Secretary.