Bill Harvey: Going for the one

Here are two opposing views.

Increasing specialisation has allowed a targeted approach to healthcare whereby individual problems may be managed by those with a proven track record in the relevant area and has led away from a jack-of-all-trades approach reliant upon someone with limited knowledge having overall responsibility for a wide range of conditions.

Increasing specialisation has led to a bottle-neck in care pathways with too few specialists available without referral through often several assessments and where a holistic approach to overall care is lost.

These represent the two ends of a line of argument that must be continually addressed in eye care. Early problem identification is now possible with new technologies and this should place the primary care practitioner in a good position to undertake a range of interventions and relieve the burden upon secondary care so allowing the specialist to focus more on their specialism.