Letter: Fundholding logic

Professor Howard Glennerster
Monday 31 May 1993 00:02 BST
Comments

Your support helps us to tell the story

From reproductive rights to climate change to Big Tech, The Independent is on the ground when the story is developing. Whether it's investigating the financials of Elon Musk's pro-Trump PAC or producing our latest documentary, 'The A Word', which shines a light on the American women fighting for reproductive rights, we know how important it is to parse out the facts from the messaging.

At such a critical moment in US history, we need reporters on the ground. Your donation allows us to keep sending journalists to speak to both sides of the story.

The Independent is trusted by Americans across the entire political spectrum. And unlike many other quality news outlets, we choose not to lock Americans out of our reporting and analysis with paywalls. We believe quality journalism should be available to everyone, paid for by those who can afford it.

Your support makes all the difference.

Sir: I was somewhat surprised by the tenor of your account of the Audit Commission's recent reports on the NHS, a small part of which refer to GP fundholding ('GP fundholding system 'should be phased out' ', 26 May).

So far from proposing that fundholding be 'phased out', as I read it, they come to the opposite conclusion. The following paragraphs come to a very similar conclusion to my own research.

228: Current experience of the fundholding scheme suggests there is benefit from this dual commissioning arrangement. GP fundholders have shown their ability to use funds imaginatively for certain services such as routine elective admissions, and to stimulate change in

providers.

Co-operation between districts and GPs was important and should be monitored by Regions, but:

231: The presumption should be in favour of practice-based commissioning, ie, GPs selecting the best package of health care for each patient within an overall practice budget.

232: There is a compelling logic about more local involvement which is missing from the present arrangements.

Precisely.

Yours sincerely,

HOWARD GLENNERSTER

Department of Social Science

and Administration

The London School of Economics

and Political Science

London, WC2

28 May

Join our commenting forum

Join thought-provoking conversations, follow other Independent readers and see their replies

Comments

Thank you for registering

Please refresh the page or navigate to another page on the site to be automatically logged inPlease refresh your browser to be logged in