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In article <[log in to unmask]>, Dr Alan Hassey <[log in to unmask]> writes >I never said this....We can gate-keep perfectly well by delegating care >of minor illness to nurses - there is a growing literature to support >this approach too. We can still maintain overall control - particularly >for all referrals (emergency, urgent & routine). I have not made any >proposal for delegating this - rather the opposite - I said we should >concentrate in the areas where we are trained and particularly skilled >history, examination, investigation, treatment (+- referral) Alan, I was free associating a bit- not every thing I wrote was a direct reply to your text. I think that there are two problems with the above paragraph. 1. Defining minor illnes: most major illnesses begin with a 'minor' symptom. 2. One of the areas in which experienced GPs are particularly skilled, though perhaps not formally trained, is in deciding what is minor and what is major. I think you will have to educate a lot of doctors as well as the patients and the nurses. Paul Paul Robinson GP & Course Organiser Scarborough %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%