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Author Archives: Jonathan Tomlinson

Only a tiny fraction of the ocean of human physical and mental suffering reaches the shores of general practice, from where barely ten per cent of patients are referred for specialist attention. GPs have been trusted to refer judiciously, according to their clinical judgement, saving time and costs of specialist interventions. This gatekeeper role is widely acknowledged to be a key feature of the NHS, which keeps it at the forefront of cost effectiveness internationally. In recent years, however, the rate of referrals began to rise – the opposite of NHS England’s strategic aim of shifting care away from hospitals. […]
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In Hackney the NHS funds more than 100 mental health organisations, ranging from support from Somali women to Sane, the national help-line and IRIS, an rape-support service. The NHS needs organisations like this. What they don’t do is cherry-pick easy cases or over-treat. Transaction (tendering etc.) costs are minimal so far as I know. It’s absolutely right that the NHS funds services like these that it cannot provide itself, but I can think of no good reason why existing NHS services should be tendered out to private providers. See my response to accusations of extremism on Radio 3. My objections are […]
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