PMID: 9428087Jan 15, 1998Paper

Paradoxes of GP fundholding: contracting for community health services in the British National Health Service

Social Science & Medicine
G WilliamsS Pickard

Abstract

The expansion of GP fundholding (GPFH) is central to the British government's attempt to maintain the revolution under way in the National Health Service (NHS). Evaluations of the NHS reforms have portrayed GPFH as an important mechanism for competition, and GPFH's bargaining power is reported to have secured significant changes in health service provision. However, these developments have been acknowledged to be less applicable in relation to community health services (CHS) than acute hospital services. On the basis of case studies of the process of contracting for CHS, GPFHs are shown to display ambivalent and sometimes contradictory views which have to be related to broader policy developments in general practice and primary care. Although this paper focuses on the British situation, many of the issues raised by reforms in primary and community health services have implications for developments in other Western health care systems.

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Citations

Aug 1, 1995·Journal of Advanced Nursing·S Cowley
Jun 3, 1999·Journal of Advanced Nursing·M Shears, M Coleman
Jun 22, 2000·International Journal of Health Services : Planning, Administration, Evaluation·S Iliffe, J Munro
May 18, 2012·Journal of Health Services Research & Policy·Pam SmithHelen Allan
Feb 6, 2013·Journal of Biological Rhythms·Katrina G SalvanteKeith W Sockman

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