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General practice fundholding Fundholders not to blame for fast tracking

BMJ 1994; 308 doi: (Published 19 March 1994) Cite this as: BMJ 1994;308:793
  1. M H Armstrong,
  2. S Iliffe,
  3. U Freudenstein
  1. Alvanley Surgery, Bredbury, Stockport SK6 2AH
  2. Department of Primary Health Care, Whittington Hospital, London N19 9NF
  3. Belgrave Medical Centre, Sheffield S2 4UJ.

    EDITOR, - More and more people who think that they know about fundholding seem to be trying to blame fundholders for creating a two tier system. They also complain that fundholders have too much money and are starving the district health authorities and commissions of funds to cater for the patients of non-fundholders. A recent article by Hart is a prime example of people talking without checking the facts.1

    In our area some practices are underfunded by up to 15% for inpatient and day case procedures. Fast tracking for them is potentially disastrous, but it is still happening. Practices in some parts of the region are having to institute contractual changes to combat this problem and prevent uncontrolled overspends.

    This occurs because the providers are tagging the fundholders' patients and then processing them quickly, not because the …

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