Dr. Laura Durcan:

Yes. With all due respect to my surgical colleagues, nobody likes cleaning up someone else's mess. It is difficult for those patients to then be cared for by someone with a surgical speciality who did not do the operation. That chronic care is a major problem for patients.

Last week, I had a lady in who had a knee operation in Santry under the NTPF. She came back in and said that she thought she needed to have her other knee done and really wanted it to be done in Santry. I said that I did not think the knee was that bad. She said that it would be two years before she got to Santry and asked if I would refer her now so that she can get into Santry in two years. I did not do that but it changes patients' expectations of how healthcare works. I think it is a very short-sighted intervention but it is necessary at times.