The abolition of the GP fundholding scheme: a lesson in evidence-based policy making

Abstract

The general practitioner (GP) fundholding scheme was introduced as part of the Conservative government's 1991 National Health Service reforms and abolished by the Labour government in 1998. This paper contends that the scheme was introduced and abolished without policy-makers having any valid evidence of its effects. In particular, it focuses on the salient features of the decision to abolish. These were: (a) that it was not based on evidence; (b) that it came relatively soon after the introduction of the scheme; and (c) the GP fundholding scheme was voluntary and increasing numbers of GPs were being recruited. The overtly political nature of the introduction of GP fundholding is already well documented and is important in understanding the lack of evidence involved in the development of the fundholding scheme.