Letter: Fundholding: bureaucratic and expensive

Sir: In the wake of the Audit Commission's Report on GP fundholding, how can the Health Secretary justify the continued expenditure of in excess of pounds 100m per annum on the administrative costs alone of this unproven scheme? By comparison the closure of a teaching hospital like St Bartholomew's will save the Government a meagre pounds 6m per annum.

It is indefensible that he refuses to resource statutorily or support the development of GP commissioning which has the potential to match, if not exceed, the purported benefits of fundholding at a fraction of the management costs. The Government has a duty to use the public purse for maximum direct patient care, rather than divert scant resources to administer bureaucratic political ideology.

Dr CHAAND NAGPAUL

Honeypot Medical Centre

Stanmore, Middlesex