Health-care systems for headache: patching the seam between primary and specialist care

Health services are rarely highly successful in meeting the needs of people with headache disorders, who everywhere are low in the priority queue. Taking the UK as an example within Europe, this paper briefly reviews the present organisation of headache services, and proposes change. The solution does not appear to lie in expanding specialist headache centres in secondary care to which most people with needs fail to gain access. A three-tier system with emphasis on primary care will, it is argued, deliver care more cost-effectively and more responsively to patients' needs.