GPs and Purchasing in the NHS

The relative performance of health authorities and general practitioners as commissioners of health care services is a crucial question in the current health care policy debate, but hitherto a poorly researched area. This work addresses that topic, and represents a systematic direct comparison of GPs and health authorities as purchasers of health care services. In doing this it centres upon two of the chief controversies about the NHS internal market: the equality of hospital waiting times for fund-holding patients, and the fairness of the budgets received by fund-holding practices for commissioning effective surgery. In discussing the policy implications of the research, the book then addresses what lessons should be learned from the internal market about equity and efficiency in the service now that the present Labour Government is reforming the NHS with the introduction of Primary Care Groups and Primary Care Trusts.