Letter

Primary care-led—or accountant-led?

Dear healthmatters—You may call me cynical, but I think David Martin has got it wrong about the ‘primary care-led NHS’.

Given the inexorable pressure on the health service budget, the fact that the majority of it is spent in the secondary and tertiary sectors (and that it is in these sectors that the greatest budgetary pressures are felt), and the fact that seemingly neither clinicians nor managers in those sectors are able to control activity, it is inevitable that those with overall responsibility should turn to the only people who can exercise effective control over hospital activity — the general practitioners who send patients to hospital — and give them the budget with which to commission hospital services.

Why else do both major political parties want to make an untested philosophy, for which there is so little evidence of benefit, such an important part of the way the service is to be run?