The British Medical Association, meeting in Torquay, decided by 189 votes to 140 to abandon opposition to a system that a quarter of family doctors already use. The figure is expected to be 40 per cent by April next year.
Dr Ian Bogle, chairman of the General Medical Services Committee of the BMA, said the policy change was essential to preserve professional unity and strengthen negotiations to remedy the flaws in fund holding.
Dr John Chisholm, a BMA council member, warned the conference that the association would be sidelined in negotiations with ministers over the development of general practice if it went on 'banging the drum' against fund holding. But some doctors accused the leadership of conceding important principles for political expediency.
Dr Sam Everington, an east London GP, said fund holding was 'destroying the doctorpatient relationship' and enabling some practitioners to make thousands of pounds in undisclosed profit. Dr Michael Whitlock, of Finchley, said some GPs in Hertfordshire found it hard to get hospital treatment for patients unless they were fund holders.
Earlier, Dr Jeremy Lee-Potter, chairman of the BMA council, made a forceful attack on government claims that the NHS reorganisation was bringing benefits for patients. He urged ministers: 'Stop pretending everything is right with the NHS when it is not. Stop introducing expensive changes and raising public expectations when you do not have the money to pay for either. We are becoming exhausted with trying to make these flawed reforms work.'
Dr Lee-Potter, who is facing a challenge to his leadership later this week, highlighted public opinion surveys showing most people were ready to pay higher taxes to maintain and improve the NHS. He told representatives: 'To many it looks as if the NHS is falling away piece by piece, like some cliff on the east coast. Eye tests, dentistry, long-term care of the elderly - what will be the next chunk to fall off into the sea?'
He scorned the appeal made earlier this year by Virginia Bottomley, Secretary of State for Health, for hospital doctors to 'pace' work through the year to stop hospitals 'over-performing' on contracted workloads.
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