Role of hospitals in NHS must not be undervalued

BMJ 1998;317:1653 ( 12 December )

Letters

Role of hospitals in NHS must not be undervalued

The first 150 words of the full text of this article appear below.

EDITOR $---$ In his clear account of the issues that will need to be addressed if primary care groups are to be introduced successfullyinto the NHS, Chisholm stated that "90% of all episodes of healthcare take place [in general practice]."¹ Although this figureis often used to justify the importance of general practice Ihave never seen it used with any supporting evidence. I thereforeinvestigated what proportion of episodes of medical care actuallytake place in generalpractice.

In the fourth national survey of morbidity in general practice, carried out in 1991-2, patients were found to have consultedtheir general practitioners an average of about 2.9 times eachyear.² Hence, in England in 1991-2 there were about 142 millionconsultations with general practitioners (2.9 × 49 million). Datasupplied by the Office for National Statistics show that in 1992about 61 million episodes of medical care occurred in hospitals(table).³ Thus, of the estimated total . . . [Full text of this article]