Fundholding: from solution to problem

BMJ 1994;308:3 (1 January)

Editorials

Fundholding: from solution to problem

General practice fundholding has become a policy problem forthe NHS. Hailed as a success only a few months into its operation,¹it now seems dogged by limited advantages, high costs, and unintendedconsequences.

So far the only demonstrable advantage to fundholders has beena reduction in prescribing costs.^2,3 This is an eccentric achievementin a country whose prescribing costs historically have beenamong the lowest in western Europe.⁴ It tells us nothing abouteither the quality of care, which may decline as costs are cut,or the long term economic costs of short term savings on prescribing,which may be appreciable.⁵

The economic costs of fundholding are considerable and includeboth open costs (such as management fees, subsidies for computerisation,and the administrative costs of billing and reviewing contracts)and hidden costs (such as costs for staff in family health servicesauthorities, hospitals, and the Audit Commission). The political. . . [Full text of this article]

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?

Relevant Article

General practice fundholding: Delivers what patients want: T Richardson, R Singer, E D M Tod, A Birchall, B A Sides, B Rumball, D G Black, A D Birchall, I M G Trimble, S O Fradd, J A G Paris, K Williams, and M Waterland
BMJ 1994 308: 475. [Extract] [Full Text]

This article has been cited by other articles:

Dixon, J., Glennerster, H. (1995). What do we know about fundholding in general practice?. BMJ 311: 727-730 [Abstract] [Full text]
Handysides, S (1994). Enriching Careers in General Practice New roles for general practitioners. BMJ 308: 513-516 [Full text]
Richardson, T, Singer, R, Tod, E D M, Birchall, A, Sides, B A, Rumball, B, Black, D G, Birchall, A D, Trimble, I M G, Fradd, S O, Paris, J A G, Williams, K, Waterland, M (1994). General practice fundholding: Delivers what patients want. BMJ 308: 475-475 [Full text]