One day, a long time ago, when I was a young GP practising in the country, a middle-aged man brought in his wife for me to assess.

She was slim, pleasant, smiled a lot, said little and was clearly delusional. He said she had been like this for many years. I had never seen either of them before.

Now, in small country towns, some patients prefer not to see the local GP and go down-the-line to a doctor in a nearby town, often a town that is one stop closer to a regional centre.

This couple had come from up-the-line. He ran a small business and, with the support of his grown-up children, cared for his schizophrenic wife.