Will doctors manage? Lessons from general practice fundholding

Under the UK Conservative government, GP fundholding represented a major in crease in the involvement of primary care doctors in the management of loca l service provision. The Labour government's proposals for Primary Care Gro ups extends and develops this role. This article examines the experiences o f fundholding of a group of general practices which participated in an exte rnal evaluation of their work. Opinions about the merits of fundholding wer e varied. Doctors and managers expressed concern about the administrative b urden and questionable clinical value of the scheme. Uncertainties about th e overall impact upon professional autonomy were also raised. These reserva tions are consistent with discussions elsewhere questioning the role of doc tors as managers within health care systems.