BMJ 1994;309:1032-1033 (22 October)

Editorials

The future of purchasing

At last week's Conservative party conference the government's plans for the future of fundholding were unveiled.1 To understand the significance of these it is important to remember the history of purchasing so far. Working for Patients established two models of purchasing, one centred on health authorities and the other on general practitioners. Health authorities approach purchasing from a population perspective and bring to bear a range of skills in public health and other disciplines to assess health care needs. On the basis of needs assessment, health authorities buy the full range of care for their population except for those services under the control of fundholders. Fundholders are responsible for purchasing a limited list of services and do so in a way that is responsive to patients' demands. There is therefore a contrast between needs based purchasing by health authorities and demand led purchasing by fundholders.

In practice, health authorities and . . . [Full text of this article]


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