Election `97: Practice bears brunt of two-tier service

In Montgomeryshire, all the GPs are fundholders except for the four partners who run the health centre in Llanfair Caereinion, who stayed out of the scheme because they believed it would create a two-tier service.

Their worst fears have been realised. As a result of their principled stand, their 4,500 patients face the longest waits of 18 months to two years for routine surgery at the local Royal Shrewsbury Hospital, while those from neighbouring practices are treated at the same hospital in an average of three months.

Dr Tony Evans, one of the partners, said: "This week a man who has been waiting over two years for an operation on his prostate had it postponed again. The hospital would not allow that to happen to a fundholder's patient because it would be breaking their contract. The patient is extremely angry. Like us, he feels it is unjust.

"The Royal Shrewsbury has now threatened that it will cancel all non- urgent surgery unless more money can be found. Since we are the only non- fundholding practice we are the only ones affected."

"We stayed out of the fundholding scheme because we believe that if you hold your own budget for hospital care it is bound to interfere with your clinical judgement. I don't think you could get a better example of how disgracefully inequitable the scheme is than by looking at our situation."