Sir: Dr T Richardson (Letters, 3 July) vents his criticism of Labour's proposal to abolish the privilege of GP fundholders in our primary health care system. He does not address the key issue about fundholding. Under the current system it gives doctors an incentive to cut down on their prescribing costs, with the further incentive that they can use the funds saved to increase their own capital worth - such as building extensions on to their surgeries - to house extra practice nurses, physiotherapists, or whatever. We all want to suppress excessive prescribing, especially of expensive brand name drugs. Can we really only do this through fundholding?
What is the essence of GP fundholding? Once you strip away from it the government flannel and the "feel-good" factor, fundholding creates for the more entrepreneurial GPs a direct cash incentive to hold down prescribing costs. Surely it is better to allow all GPs to switch from brand name drugs to cheaper drugs, not just fundholders. All the GPs in the area can then make collective decisions to spend the money on extra treatments. This is what locality commissioning will provide.
MP for Cardiff West (Lab)
House of Commons
The writer is Labour Shadow Welsh Health Minister.