The Response of Fundholding Family Doctors to Price Signals

The introduction of budgets for family doctors to purchase health services for their patients was a major part of the internal market reforms in the UK health service. The paper examines the response to price signals of 35 fundholding GP practices during the first four years of fundholding. Admissions increased and the private sector was used for a small level of provision, but great diversity was apparent between individual GP practices. Despite huge potential savings from changing referral patterns, only very minor changes were observed. GPs used the power of fundholding to instigate change in the services provided by existing suppliers rather than to respond to more attractive prices from alternative suppliers.