Letter

Innovation in co-operation

Innovation in co-operation

Dear healthmatters- As more GP practices prepare for fundholding status I would like to descibe the scheme that exists in Tower Hamlets, east London, in which contract negotiations aim to benefit the practices.

A GP representative is involved in each contract specification group, along with a purchaser from the health authority and a provider from the local trust hospital. The GPs report back to a forum, which meets approximately six-weekly and is open to all GPs working in Tower Hamlets to attend.

This involvement brings all the advantages which are claimed by fundholders in the negotiation of contracts, but the difference is that they are available for everyone, not just a privileged few who can get a better service because others are moved down the queue.

An example of how this system has been of benefit is demonstrated by the ENT department. Last year the wait for an ENT outpatient appointment was nearly 6 months. This was obviously unacceptable, and in order to hold a contract, the trust has to agree to offer more consultant sessions. This has occurred and the wait is now about 2 weeks.

There are no fundholding practices in Tower Hamlets as the majority of us feel that the division of health care in this way is not the answer. But it is important that GPs are involved in the determination of the service which is available to their patients. This scheme, I feel, enables this to happen without the development of a two-tier NHS.