[Transferring care from secondary to primary health services; time for action]

Transferring responsibility for care from secondary to primary health services is a hot topic in Dutch health care. The theory is that this is cheaper, while providing the same quality of care, and practice guidelines have actually stimulated this process for many years. Researchers from the Netherlands Institute for Health Services Research (NIVEL) explored how this transfer of care has been accepted and how the process can be expanded. The fact that there is a great difference in referral rate between general practitioners led them to conclude that there is still room for more transfer of care. One problem is that general practitioners in the Netherlands have too many job responsibilities, and no single general practitioner can fulfil all requirements. Although further transfer would be cost effective the organisation of health care needs to be remodelled if more services are to be transferred. Physicians should be stimulated to collaborate more effectively and medical training should focus more on this competence.