• primary care
• ophthalmology
• United Kingdom

Riad and colleagues have presented us, in this issue of BJO (p 493), with an interesting and thorough review of primary care especially as it applies to ophthalmology in the United Kingdom. In their far ranging article the authors consider topics such as the history and definitions of primary care, the attributes of good primary care, and the primary-secondary interface. The review accurately portrays the complexity of primary healthcare provision and implicitly raises the question of how such a complex system can be planned, managed, or evaluated. The review will be particularly helpful when health service researchers need to view ophthalmic primary care as a whole because it is not sufficient for them merely to concentrate on one specific aspect.

Most health service research concentrates on the qualities of some small part of healthcare provision, perhaps suggesting how that particular aspect could be improved. While important, this approach sometimes ignores the knock-on effect that changing one part of a service will have on other provision. The coverage of …