BMJ  2006;332:552 (4 March), doi:10.1136/bmj.332.7540.552-a

Letter

Secondary care is not evil

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

EDITOR—Although secondary care has come to expect hospital and consultant bashing as a government pastime, it is disappointing that the BMJ, under the editorial by Lewis,1 follows the party line. It is not secondary care that drives unscheduled activity but patients. Hospitals are not "sucking" funds from primary care in some grotesque saprophytic manner. The opposite is true in practice.

Secondary care trusts, through emergency care networks, have been attempting various admission avoidance strategies to reduce the excessive demands placed on emergency admissions areas and accident and emergency departments. The NHS in England Operating Framework 2006-7 sets a differential payment by results tariff for emergency care above 2004-5 (+ 3.2%) rates of only 50%.2 Not only will primary care trusts and the government get emergency care on the cheap, but the editorial implies that secondary care trusts should be being punished in this way for meeting the . . . [Full text of this article]

Nigel D C Sturrock, clinical director, acute medicine

Nottingham City Hospital, Nottingham NG5 1PB nsturroc@ncht.trent.nhs.uk


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Rapid Responses:

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Secondary care is not evil
John H Coakley
bmj.com, 3 Mar 2006 [Full text]
Re: Secondary care is not evil
Roberta Smith
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