ABSTRACT
This chapter addresses what are the reasons for believing that this method of producing health care will produce advantages in terms of quality and cost? The framework it uses for thinking about this question is essentially the same as that underlying the official reports and other documents cited. The general hospital by its nature is large in terms of scope, ie its range of activity comprises most medical specialties, as well as the support services these require. There are a large number of small hospitals working in a very narrow range of specialties. These hospitals are small in terms of scope and most are small in terms of scale, that is, in the areas in which they work, they carry out only a modest number of operations or procedures relative to the general units. The clinical case for physical proximity turns on the availability of the doctor providing consultation and diagnostic services for inter-professional consultation.
