Fundholders' leaders have quite rightly come to the conclusion that the model has run its course (see News Focus, page 15). Contrary to their earlier predictions that this would send GPs into an apathetic sulk, however, it seems they have now decided to see the advent of commissioning as an opportunity.
Rhidian Morris, chair of the National Association of Fundholding Practices, was at his most positive last week in telling an assembly of the fundholding faithful that it was down to them to harness their energy and enthusiasm to make the new reforms work for them. That is a welcome change of heart.
But whether he was right to predict that the advent of primary care groups posed no threat to the continued vitality of practices as the basic unit of primary care organisation is debatable. There are plenty of reasons to believe otherwise and to believe that this might also be a good thing.
His suggestion that health authorities would defend their management cost allocations with the excuse that they need the money to deliver the public health agenda suggests that NAFP has not yet understood the far- reaching implications of the Our Healthier Nation green paper for primary care.
GPs will still see the patient in front of them as their prime focus. But, perhaps for the first time, PCGs will empower the best of those working in primary care to get to grips with the health (not just sickness) issues facing populations. NAFP's successor body should play its part in that work.