The Abolition of the GP Fundholding Scheme: a Lesson inEvidence-based Policy Making

The GP fundholding scheme was introduced as part of the Conservative government’s 1991NHS reforms and abolished by the Labour government in 1998. This paper presents theargument that very little was learnt about the effectiveness of the scheme before its abolition.This was because there was no systematic evaluation of GP fundholding and the decision toabolish it was taken relatively soon after its introduction. The implication for general practicepolicy has been that in the design of financial management incentives for Primary Care Groups(PCGs) there has been no means of identifying which elements of the fundholding schemeshould be incorporated. . A more evidence-based approach to policy-making is required and thechallenge for general practice research is to produce a detailed analysis or model of the significantmotors of change in NHS general practice.The paper has a section that charts the development of the initiative, from its introduction inApril 1991 to its abolition in March 1999. Another section examines the findings of the limitedrange of available studies on the operation and effects of the scheme are reported. A furthersection examines the implications for primary care research and policy of the decision by theLabour government to abolish of the scheme.[...]