Bureaucracy of purchaser-provider split delays treatment: Table 1

Editor—Before the National Health Service and Community Care Act 1990 came into force,1 general practitioners were free to refer their patients to the consultant of their choice at any hospital. Our general practitioner referrals were categorised rapidly by medical staff as urgent, soon, or routine, and the clinic reception staff organised outpatient appointments generally within one week, two weeks, or 12 weeks, respectively, in our department. Since that act came into force, a new bureaucracy has been created to deal with those referrals made by non-fundholding general practitioners to their first …