Internal market is unjust

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6931.794 (Published 19 March 1994) Cite this as: BMJ 1994;308:794
  1. A M Pollock
  1. Department of Public Health Services, St George's Hospital Medical School, London SW17 0RE.

    EDITOR, - Virginia Bottomley states that “priority setting should ensure a fair distribution of what is available1“ but disregards accumulating evidence that the internal market is eroding this principle.2 Access to NHS care is now determined by purchasers' ability to pay and to choose patients. First wave general practice fundholders and their patients benefited from generous resource allocation at the expense of the patients of non-fundholding practices in the same districts. This has enabled fundholders' patients to bypass waiting lists for elective work while lists are closed …

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