General practioner fund-holding was an idea hatched in the early 1980s but introduced only at a late stage into the NHS reforms outlined in the 1989 white paper Working for Patients. Giving large general practices a budget for drugs, staff and certain hospital services was seen as having a number of advantages. It would provide an incentive to GPs to make economic use of these resources; it would empower GPs to improve hospital services by acting as informed purchasers on behalf of their patients; and it would provide a method of cash-limiting important elements of NHS expenditure by devolving to GPs the responsibility for rationing their use.
KeywordsBritish Medical Journal Hospital Service Referral Rate Community Health Service Core Service
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