ABSTRACT
The traditional gatekeeper role of the GP may still be experienced in positive terms as the representative of community systems, acting as their interpreter and functioning as an editor of information. This chapter describes the referral process as a mechanism of the deployment of resources by transfer between care systems. The phenomenon of edited information is part of a distancing effect that is created between care systems, and where this happens it has categorized the relationship between care systems as aggressive dependence. The more custodial the institution, the more the aggression is about the maintenance of intact boundaries, both of the individual and of the institution, against the outside world. This aggression is evident in any dependent relationships between systems; the aggression that we see characterizing the total institution has found an outlet in the potential for transfer of accountability between care systems.
