Letter: The human cost of fund-holding

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Sir: I write as the retired senior partner of a non-fund-holding practice, in response to your article "GP's pounds 513,000 expansion raises fear over profits" (26 May).

When fund-holding was introduced, it was generously funded. In addition GPs were told that savings on this notional budget (mainly through reduced prescribing costs) could be transferred to "other aspects of patient care". These include the employment of health care personnel and the provision of improved buildings for patient services.

Bearing in mind the fact that buildings become the property of the doctors concerned, and may be sold on retirement to their own financial advantage, GPs are faced with a clear conflict of interest. This arrangement was a cynical move by the Conservative government to entice GPs towards fund- holding. Is it a wonder that some may take advantage of the situation? We are all human, and have our price.

Whilst sorting out the mess the NHS is in, the new Labour government should act quickly to abolish this conflict of interest by making it impossible for any savings from the fund-holding budget to be used to enhance GPs' equity.

Dr A C MARKUS

Thame, Oxfordshire

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