Letter: NHS fundholding wastes resources

Sir: Graham Blincow (letter, 27 July) is wrong to claim that fundholding makes the best use of limited NHS resources.

In Oxfordshire, fundholders have accumulated pounds 3.5m of unspent savings. If they have any plans to spend it, such plans are mainly for extensions to surgery buildings. Meanwhile, the Oxford Radcliffe Hospital is cutting down on elective surgery for non-fundholding practices' patients and lengthening waiting times, in breach of the Patients' Charter. It is having to do this because of a shortfall of half a million pounds in the funding available from Oxfordshire Health Authority.

The direct administrative costs of fundholding in Oxfordshire were pounds 1m in 1994-95; they will be higher now. Most of fundholders' savings in Oxfordshire now come from the budget for hospital services - but a study in the Oxford region shows that the rate of referral to hospital by fundholding practices has actually increased over time. This calls into question the validity of the budget-setting process.

Fundholding wastes NHS resources, is inequitable, and should be ended.

Dr DUNCAN KEELEY

Thame, Oxfordshire