Fundholders 'not spending savings on patient care'

FUNDHOLDING family doctors have 'saved' pounds 49m on money paid to them by the National Health Service over two years and spent it on expanding their premises or buying computers and mobile telephones rather than directly on patients, a Labour MP claims.

A survey of how savings were spent, carried out by Dawn Primarolo, a Labour health spokeswoman, showed that up to 47 per cent of the savings made were spent on improving or building premises. If the business was then sold, the doctor could 'pocket' the profit, she said.

The survey was conducted after the Department of Health and five of the eight regional health authorities refused to give a breakdown of how the savings had been used, saying only they would be spent on 'patient care'.

GP fundholders are not allowed to keep as personal profit the money they do not spend on purchasing health care from hospitals.

Labour accepts that some refurbishment of premises may improve patient care indirectly. But it argues the savings should be repaid to the health authorities to be spent on priorities such as employing more medical staff in hospitals and reducing waiting lists.

The amount of savings that fundholders have amassed has led to allegations that they are profiteering. Labour objects to fundholders being able to sell their improved businesses at a profit, as the NHS does not retain any interest in the equity. The Audit Commission is due to begin an audit of GP fundholding next year.

The survey showed fundholders in the North West region saved pounds 5.13m over the first two years of the scheme, in 1991-92 and 1992-93, of which pounds 2.41m or 47 per cent was ploughed back into premises. In one case pounds 71,000 was spent on alterations to a surgery.

In the West Midlands pounds 1.4m of pounds 8.2m savings was spent on premises and in South Thames pounds 800,000 of the pounds 4.4m savings went on buildings. Nationally pounds 17m was saved in the first year and pounds 32m in the second.

The Government is determined to bring in locally varying pay for doctors, Gerald Malone, the health minister, said last night, on the eve of a British Medical Association conference to discuss the issue, writes Celia Hall.

In what was seen as a strong challenge to hospital doctors over local pay bargaining, Mr Malone made public a letter he has written to Dr Sandy Macara, the BMA chairman, stating: 'No one should be under any illusion about the Government's resolve to introduce local pay arrangements in the NHS.'

Salaried NHS doctors are opposed to local pay arrangements and performance-related pay, which they say are inappropriate for the profession and will break up a national health service.