Letter: Little point in fundholding

Sir: The leaked National Audit Commission Report ("Fundholding: 'GPs cannot cope' ", 13 May) suggests that many fundholding practices have produced little benefit for anyone apart from themselves. Our own statistics from Devon would support this.

Any benefits from fundholding must be pretty small, as 95 per cent of Devon fundholders' contracts are with local Trusts, who provide exactly the same services to the patients of both fundholding and non-fundholding GPs. Neither are the savings spent directly on patient care. This year 99 per cent of fundholders' savings in our district (pounds 22,500 per practice) will be spent on practice buildings, furniture and equipment, for which non-fundholding GPs have to pay out of their own pockets.

Fundholding practices will also receive pounds 35,000 per practice from outside funds for management and computers and be able to spend between pounds 20,000 and pounds 25,000 per practice extra on staffing. These are the reasons that many practices have become fundholders though they may not have told the National Audit Commission this. If you need a new computer you more or less have to become a fundholder these days.

It is unreasonable that fundholding practices can access large central funds while GP commissioning practices are unable to. It is also unreasonable that the practice and personal income of a GP should suffer because he chooses GP commissioning in preference to fundholding. Particularly so when peer-reviewed research fails to demonstrate any consistent benefit to patients from fundholding and when the Department of Health continues to obstruct any serious research into GP commissioning.

Dr Michael Dixon

Secretary

Mid-Devon Doctors

GP Commissioning Group

Cullompton, Devon