integrate their health care and view their problems together rather than in isolation, and who can protect them from over-investigation and over-treatment -which Toon characterises as the 'furor therapeuticus' of specialist medicine (16). Patients as a whole benefit because the system ensures that expensive secondary care resources are spent on those who have the greatest need.

Some people however are concerned that gatekeeping can damage the doctor-patient relationship, since the doctor cannot act solely in the interests of the individual