Conservatives would resurrect GP fundholding if they came to power
A Conservative government would bring back GP fundholding in England, but under a different name, party
leader David Cameron seemed to suggest when he spoke at the influential health think tank the King’s Fund this week.
He promised that GPs would be able to retain their own budgets for spending
on patient healthcare — the same principle which underpinned fundholding
introduced under the previous Conservative administration in the early
1990s but abolished by the Labour government after it came to power in
1997.
He said: “In a nutshell, GPs should control the budgets that NHS
patients are entitled to. There is good economic rationale for this.
Budget-holding is a natural guarantee of efficiency, ensuring that money
follows the patient and it is spent on frontline care rather than on
bureaucracy.
“GPs — rather than remote managers — should be
responsible for reconciling the available resources with clinical priorities
and patient choice.”
Budget-holding would ensure continuity of patient care, he claimed. “Even
though the patient may see many specialists there is always one doctor
in charge: the doctor closest to the patient,” he said.
Commenting on the idea, head of NHS services at the Pharmaceutical Services
Negotiating Committee Alastair Buxton said: “It does seem similar
to fundholding — but then how much difference is there between
fundholding and practice-based commissioning, which we have now?”
If budget-holding were introduced, he said, its impact on pharmacy would
depend on what services GPs were entitled to spend the money on.
Under the present funding system primary care services such as pharmacy,
dentistry and optometry remain commissioned nationally via primary care
trusts, he pointed out.
He said: “I don’t think budget-holding would impact on pharmacy — it’s
just PBC rebranded.”
Polyclinics Mr Cameron also took the opportunity during his speech to
the King’s
Fund to comment on the proposed London-wide network of polyclinics or super surgeries
put forward by health minister Lord Darzi in his Healthcare for London review.
Although he thought it was often a “very good thing ” for GPs to
share their premises with other health professionals such as pharmacists, he
did not support the idea of polyclinics being imposed on local communities.
He said if Darzi’s polyclinic model were rolled out nationwide it would
represent the biggest upheaval in primary care since the creation of the NHS
or since the beginning of modern general practice in the 19th century. It would
threaten the survival of 1,000 GP surgeries in London and up to another 600 across
England, he claimed.
He said: “The Conservative party will fight Labour’s plans to close
GP surgeries. We pledge to save the family doctor service from Gordon Brown’s
NHS cuts.” |
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Pharmaceutical Journal
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