Despite the end of fundholding, old enmities continue
The internal market is dead. Fundholding is discredited and we're all commissioners now. But the launch of the National Association of Primary Care this week, and the response of its main rival, shows old enmities live on (see News, page 4; News Focus, page 14).
The NHS Primary Care Group Alliance is understandably miffed. It championed commissioning as financial incentives were channelled into fundholding. With the advent of a Labour government, it thought its time had come. Alas, ministers appear to have other ideas. No doubt the government is keen not to upset a substantial body of GP opinion. But its attentiveness to an organisation which was until not so very long ago in the vanguard of fundholding is pretty astonishing.
Many will draw the conclusion that while the government has adopted commissioning GPs' language, it has stolen its ideas from fundholders. The jibe that it has taken fundholding and made it compulsory rings ever truer. It certainly addresses the 'two-tierism' problem. But it will take little heat out of the ideological battle within primary care. The fight for the soul of commissioning looks set to be a humdinger.