'Fundholding' is worth this second chance
Long after its demise, fundholding remains an issue guaranteed to divide GPs. For some it put commissioning power where it belonged and led to improved services. For others it was open to abuse and created a two-tier system. So the Government's plans for practice-led commissioning, which have strong echoes of fundholding, will cause rumbles of discontent and raised eyebrows of interest in equal measure among GPs.
Ministers say the new scheme avoids the problems of fundholding because PCOs will keep hold of the budget GPs use to commission services – and any savings they accrue. Yet they also say they are happy for PCOs to give GPs incentives if they save money and improve care.
Giving GPs the power to commission services should improve care and deserves to be given a chance to succeed. But it is vital the excesses and inequities of fundholding are not repeated.