Fundholders have saved pounds sterling111m since 1991

By 31 March 1994 general practice fundholders had saved pounds sterling111m but spent only pounds sterling19m, according to a report from the Audit Commission. In its Briefing on GP Fundholding the commission says that of the pounds sterling19m, 35% has been invested in doctor's premises, 25% on furnishings and nonmedical equipment, 15% on medical equipment, and 25% on hospital and community services.

Spending on premises is legitimate, but the commission's controller, Mr Andrew Foster, said, “If there were major patient services not being offered while money went into building, then that would have to raise a question.” Fundholders have four years to spend any budget surpluses, and the past president of the National Association of Fundholding Practices, Dr David Tod, said that fundholders had been advised to retain part of any budget surplus against possible overspends in subsequent years.

The report shows that nearly one in three practices is now fundholding, that 41% of patients in England and Wales are registered with a fundholding practice, and that fundholders manage about 8% of all spending on hospital and community health services; this could rise to 14% from April 1996. The population covered by fundholders varies across Britain from 4% in Camden and Islington Family Health Services Authority in London to 84% in Derbyshire and the Isle of Wight. The average fundholder has a budget of pounds sterling1.7m, and most fundholders have between pounds sterling140 and pounds sterling170 per patient.

The commission surveyed more than two thirds of all fundholders for its interim report and will now …