Suter's article is well reasoned and accessibly written. She takes the concept of interactive sub-systems further than Atun (2009) and builds on Golden's 2004 star-system conceptual model. Nicely laid out and filled with useful references. The next step, perhaps, is to extend this model to an understanding of social services and mental health as part of the integrated mix of services. There are too many linkages amongst these three areas to ignore them as the further evolution of integrated and sustainable primary community care.