The case of Gretel. Why general practitioners must be part of the public hospital system.

A case of inappropriately delayed admission of a patient with an acute psychiatric illness is briefly described. Everyday experience suggests the hypothesis that in the current environment of predominantly publicly funded health care, the need for rationing increases the risk of inappropriate refusal to admit. It is suggested that GPs may have a role to play in optimising the allocation of health care resources and should be empowered to actively participate in the hospital care of their patients. Promoting awareness of the GP's unique role in patient care may reduce resistance to allowing GPs access to the public hospital system.