How general practice is funded in the United Kingdom

David P Weller and Alan Maynard
Med J Aust 2004; 181 (2): . || doi: 10.5694/j.1326-5377.2004.tb06188.x
Published online: 19 July 2004

The National Health Service (NHS) has undergone fundamental reform since 1948, but the fabric of UK general practice remains more or less intact. Fundholding was probably the most significant change in financial arrangements (Box). Essentially, this was an experiment for the NHS to contain costs, stimulate competition and bring resource allocation decisions closer to the patient — fundholding general practitioners assumed significant roles in local healthcare economies. Nevertheless, there was much debate over whether it was equitable. Many saw it as a basis for partnerships with the private sector and fragmentation of the healthcare service.1 Others showed that it reduced non-emergency medical admissions.2

  • 1 Division of Community Health Sciences: General Practice Section, University of Edinburgh, Edinburgh, Scotland, UK.
  • 2 Department of Health Sciences, University of York, York, UK.


  • 1. Pollock A, Dunnigan M, Gaffney D, et al. The private finance initiative: planning the “new” NHS: downsizing for the 21st century. BMJ 1999; 319: 179-184.
  • 2. Dusheiko P, Gravelle H, Jacobs R, Smith P. The effects of budgets on doctor behaviour: evidence from a natural experiment. Technical Paper 26. York: Centre for Health Economics, University of York, 2003. Available at: (accessed Jun 2004).
  • 3. Moon G, Mohan J, Twigg L, et al. Catching waves: the historical geography of the general practice fundholding initiative in England and Wales. Soc Sci Med 2002; 55: 2201-2213.
  • 4. Gosden T, Sibbald B, Williams J, et al. Paying doctors by salary: a controlled study of general practitioner behaviour in England. Health Policy 2003; 64: 415-423.
  • 5. Maynard A, Bloor K. Do those who pay the piper call the tune? Health Policy Matters Issue 8, October 2003. University of York. Available at: (accessed Jun 2004).


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