Letter: The future of the NHS: political consensus and the divisions that remain

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The Independent Online
Sir: If, as you report (16 and 17 June), Labour eventually adopts a pledge to abolish GP fund-holding, this will come as a bitter disappointment to 10,000 fund-holders in this country, and to their patients; it will also be a severe blow to practices, such as mine, that are planning to adopt fund-holding in the near future.

GP fund-holding has helped to rejuvenate the National Health Service. Indeed, it represents the most significant transfer of power in favour of clinical professionals and their patients since 1948.

Yet, having complained about excessive bureaucracy in the NHS, Labour now wishes to replace fund-holding with a far more bureaucratic system of committees. The basis of its approach is that, apparently, GPs cannot be trusted with real decision-making power; we have to be given only "notional budgets" instead.

Labour's fundamental concern appears to be their belief that fund-holding has created a "two-tier" service. However, it fails to recognise that the improvements that fund-holders have pioneered for their patients have often spread to the benefit of other patients too. By releasing the forces of innovation, fund-holding has led to substantial improvements in the care which all patients receive. This process will be accelerated by the Government's plan to extend fund-holding.

Labour's apparent desire to abolish excellence in all its forms - to level down rather than level up - betrays a lasting fondness for the misguided tenets of "old Labour". It is ironic that, in his desire to strike a populist note on the health service, Tony Blair remains oblivious to this fact.

Yours faithfully,


Croase Orchard Surgery



19 June