ABSTRACT
Patient-guaranteed care will be a core package of services, legally enforceable by the individual and backed by Government. The NHS core package would be expected to cover primary care, hospital care, mental healthcare, community care, pharmaceutical spend and emergency care, and deal with serious and long-term illness. In a patient fund-holding structure there would be incentives for people to contribute additional money if they wish to buy services which the tax base will not afford. The core package will have to specify to which generic and which prescription drugs patients will have access, and this will need to be kept up to date. In the USA, elderly Americans fear the dilution of services in this way. Patient fundholding, or the concept of direct control of cash, argues that the most direct benefits will accrue to the individual if they are given a voucher with which to secure these services.
