Communication by letter was assessed between hospital consultants and general practitioners for outpatients and inpatients referred to the Ards Hospital during the month of January 1993. The information was assessed to be poor in several sections of 104 outpatient referral letters, and of 89 inpatient referral letters despite a high use of the standard referral letter form. Consultant physician...

I REGARD myself as being greatly honoured and privileged to give this, the first Stephen Garvin Memorial Lecture. I met Stephen Garvin for the first time more than thirty years ago, and all his subsequent lifetime I enjoyed his personal friendship and that of his family. Apart from our medical association we had a common interest in another of his activities and he taught me a great deal. He ha...

examined and have chest radiography performed. If pneumothorax is confirmed the patient should be referred to a respiratory physician. Such patients tend not to have primary lung disease and so their case will be amenable to observation or simple aspiration of the pneumothorax, which can often be performed as an outpatient procedure, avoiding the trauma of chest drainage. When the pneumothorace...

The government has decided that its monetarist policy should extend into the management of the NHS. In 'Working for Patients' the government outlines its policy which, in essence, is a blueprint for controlling the ever-escalating costs of health care. It seeks to exert this control by a two pronged budgetary approach, one at regional level and one at the basic provider level. The regional budg...