GP fundholders given hope of budget reprieve

GP fundholders could be given a reprieve following assurances by Chris Smith, shadow Secretary of State for Health, to doctors' leaders that he would allow flexibility in his plans for replacing them with commissioning groups.

Leaders of the British Medical Association emerged from the meeting saying they were encouraged that Mr Smith would allow some GPs to hold budgets provided they were permitted by other GPs in their locality.

Mr Smith's aides said fundholding would be replaced by joint commissioning for NHS care within four years of a Lab-our government taking office.

But the promise of flexibility could forestall the threat of a campaign to stop the plans by some GP fundholders. John Chisholm, deputy chairman of the GPs' committee, said: "Chris Smith was pragmatic and sensible about it. I think his policies are still evolving. It would be ridiculous for the average fundholder to conclude from what we heard that fundholding will be dead under a Labour government."

However, Mr Chisholm said BMA leaders told Mr Smith that about a third of Britain's 30,000 GPs would like to continue with fundholding.

Stephen Dorrell, the Secretary of State for Health, is planning to go on the offensive next week by announcing that 53 per cent of all doctors are now voluntary fundholders who would be hit by Labour's plans. Sources close to Mr Dorrell said Labour had claimed the GPs joined against their will. "The BMA had given the lie to Labour's claims," the source said.

BMA leaders last night denied they were on a collision course with Labour and rejected reports they had given Mr Smith "some home truths" in their meeting, which had been called to clarify Labour's plans.

Labour's election manifesto next week will pledge to replace fundholding with joint commissioning by GPs co-operating to supply care, ending the system under which fundholders can enable patients in effect to jump the queues for treatment by NHS trusts.

The BMA said there were still a lot of "grey areas" in Labour's plans. "We think those who entered fundholding have put in a massive amount of time, effort and money and clearly we don't believe it can be abandoned overnight," said a source.