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Published online by Cambridge University Press: 27 May 2011
What I have to say follows on very naturally from what Dr. Johnson has just said. I ought to explain that in the United Kingdom we work in somewhat different situations from yours in the United States, from the administrative point of view, but most particularly from the financial funding point of view. Under the National Health Service we are not paid per item of service; we get a lump sum on which we have to run our departments. If we see two patients or if we see a million patients it makes no difference. In many ways, if we see few patients we can give them a better service than if we see many. I realise that this is a concept which is perhaps new to those of you in the United States, that your income in fact comes from numbers of patients.