The drawback is that they may provide weak incentives to maintain or improve the quality of care. Fee-for-service and salary schemes are likely to lead to overprovision of healthcare. However, there have been attempts within fee-for-service schemes to limit cost increases by reducing fees and combining them with hard budget constraints (Moreno Serra, 2013; Paris and Devaux, 2010). Under the GPs' fundholding policy, GPs could choose to have a fixed budget to finance some types of elective surgery for their patients and retain any surplus.