The practice of 'fast-tracking' patients of fund-holders into hospital beds and clinics is extensive and deliberate, says the Association of Community Health Councils of England and Wales in a report today. It has found 'strong evidence' of a two-tier hospital system.
One Midlands CHC obtained a hospital memorandum that listed priority patients as those who were clinically urgent, or belonged to GP fund-holders, or had waited for more than 11 months. One man in the South-east said he had been waiting 18 months for a knee operation while his son, with the same condition but with a fund-holding practice, was seen in eight weeks.
Brian Mawhinney, Minister for Health, said he viewed the findings with scepticism. 'I hope the association is not decrying the dramatic improvements in patient care delivered by GP fundholders,' he said. 'It is clearly right for hospitals with spare capacity to make services available. In all cases which have been brought to us with claims of a two-tier system we have discovered it is a case of extra services.'
Under the NHS reforms, GPs can elect to manage their own budgets entirely, paying hospitals and other providers of health care for the treatment each patient needs. These GPs negotiate their patient contracts with the hospitals. Many of these are advantageous.
Fund-holding and Access to Hospital Care; Association of Community Health Councils, 30 Drayton Park, London N5 1PB; pounds 3.