ABSTRACT
The relationship between doctors and social services assumes particular importance for the success of any total purchasing scheme. This has become of even greater significance with the government's promotion of community care. Historically relationships between GPs and social services have not always been cordial. Care in the community is a laudable concept but it is not cheap, and many people have to be cared for in nursing homes. The balance has to be struck between these two concepts of care. A recent document from the Department of Health on NHS responsibilities for meeting continuous care needs states that 'the NHS has a clear responsibility to arrange and fund services to meet the needs of people who require continuing health care'. Total purchasers must work with all other agencies to streamline bureaucratic procedures to ensure minimum delay. It is the total purchaser who will watch the 'taxi meter' clocking up the cost, and the patient and the nation who lose out.
