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Thank you Dr Spence, always thought provoking, but the themes of medicine are not constant over time and geography, they are contingent on history, society and culture, so it is no surprise that things are changing. Us part-timers may not know our patients as well, but we try to preserve our health and sanity, and may bring useful knowledge to medicine gained from our other activities, such as history or indeed, journalism.
Answer: merge primary and secondary care. This would stop the 'divide and rule' policy that has hospitals competing for CCG funding. The coalition has Regionalised the Health Service so that it will no longer be a National service after April 2013. That is what underpins the new Commissioning Board.
If hospitals were empowered to open their doors to General Practice our patients could benefit from a 'one-stop-shop' model - communication channels would improve and clinical pathways would be cleared of obstructions. Imagine, a GP being able to request an MRI for their patient without waiting weeks for a junior hospital doctor getting permission from their Consultant - brilliant!
Re: A conspiracy of anonymity
Thank you Dr Spence, always thought provoking, but the themes of medicine are not constant over time and geography, they are contingent on history, society and culture, so it is no surprise that things are changing. Us part-timers may not know our patients as well, but we try to preserve our health and sanity, and may bring useful knowledge to medicine gained from our other activities, such as history or indeed, journalism.
Competing interests: Part-timer!