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In 1991 we predicted the new contracting system introduced by the NHS Bill would reduce referrals to specialist units, particularly supra-regional units (Dolan &amp; Norton, 1991), and that any resulting decline in patient numbers might lead to the suggestion that these resources were surplus to requirement and hence not viable in a market economy (Dolan &amp; Norton, 1990).

One year after the NHS Bill: the extra-contractual referral system and Henderson Hospital