GP practice budgets: an evaluation of the financial risks and rewards
The proposals for GP practice budgets introduced by the 1989 White Paper, Working for Patients (Cm.555), represents a major departure from the original philosophy of the NHS. The Government set out in a DOH 1990 paper, NHS Review Working Paper (3), their belief that:
. . . practice budgets offer GPs an opportunity to improve the quality of services on offer to patients, to stimulate hospitals to be more responsive to the needs of GPs and their patients and to develop their own practices for the benefit of their patients. It will also enable the practices which take part to play a more important role in the way in which NHS money is used to provide services for their patients.
In the first wave, which commenced in April 1991,306 GP practices decided to become budget holders, around three per cent of practices in England and Wales. A second wave of practices are due to become budget holders from April 1992.
In this paper we consider the progress to date of those GP practices which have decided to take on this measure of financial management and accountability. We note that already, within the first year of operation, both GP fundholders and District Health Authorities (DHAs) have developed a number of budget ploys. As part of our work we report on the findings of a pilot survey of GP budget holders in the Kent Family Health Service.