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THE IMPACT OF FUNDHOLDING ON PRIMARY HEALTH CARE: ACCOUNTS FROM SCOTTISH GPS
Author(s) -
Llewellyn Sue,
Grant Judith
Publication year - 1996
Publication title -
financial accountability and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.661
H-Index - 44
eISSN - 1468-0408
pISSN - 0267-4424
DOI - 10.1111/j.1468-0408.1996.tb00418.x
Subject(s) - primary care , global positioning system , business , primary health care , geography , environmental health , regional science , health care , medicine , family medicine , economic growth , economics , computer science , telecommunications
At the inception of the internal market in health care GP fundholding was seen rather as a ‘sidesho’ to the main reforms. But as the reforms have worked through, GP fundholding has emerged as pivotal to the purchaserlprovider agenda and the changes now associated with GP fundholding will be major issues in directing future health care policy initiatives. Drawing on empirical data from three Scottish regions, this paper argues that fundholding is now significant because GPs perceive benefits for primary health care. The paper uses the data collected from the case studies in the regions to assess these gains on two levels: the ‘micro’ impact of fundholding on primary health care processes and the ‘macro’ issues raised for health care policy by involving GPs more closely in resource management. Some GPs wish to use resource management as a vehicle for enhancing equity within the NHS, others are more concerned to manage resources so as to expand their practices into sites which combine primary, secondary and community health care, still others envisage developing the market to include monetary rewards for ‘efficient’ practices.