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We need real joint working

Since the 2006 white paper introduced plans to bring ‘care closer to home' hospital activity has gone up by 40%. Not a great track record.

And where are GPs supposed to find the capacity and expertise to replace consultant clinics? Unless we find a way to make hospital consultants, GPs and community services work together and have joined incentives, this will not work.

Why not allow local health economies – hospitals and catchment GPs and community services – to take on their population's budget as a joint venture, with incentives for staying within budget? Together they can really do it and quality can be checked through outcome targets and patient satisfaction checks.

Dr Oliver Bernath
Chief executive officer, Integrated Health Partners