Letter

Should fundholding survive?

Dear healthmatters — Your editorial in the last issue (Why the doctors don’t know best, issue 27) gave a very misleading and one-sided view of fundholding, and was very offensive in suggesting that GPs have ‘never been fully a part of the NHS’.

In point of fact, fundholding has been a great success for the NHS, and that is why more and more GPs are joining the scheme. Fundholding has improved services for patients, shortened waiting times, reduced unnecessary prescribing, produced innovation in many practices, and shifted the balance of power away from hospitals and towards primary care. What more could you want?

You argue that fundholding GPs are unaccountable — but they are subject to a good deal more scrutiny than powerful hospital consultants, who are still able to disappear off to the private sector during working hours with minimal come-back from managers.

It may be that fundholding turns out to cost more than the cheap-and-cheerful general practice which has hardly changed since 1948. But, in my view, it will have been worth every penny because it is so much better than what went before.