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'Cynical' GPs accused of referral ruse

GPs have cynically increased the number of patients they

refer in order to make easy savings when they take over as practice-based commissioners, a report by health economists has claimed.

Groups of doctors have hamstrung PCT plans to reduce demand on secondary care by operating 'tight clinical networks', the report from the University of York says.

A 4.5 per cent rise in demand for elective hospital activity

in south Yorkshire between 2003/4 and 2004/5 was the result of GPs 'increasing referral rates in the mistaken belief this will secure them larger practice-based commissioning budgets', it said.

Report author Dr Andrew Street, senior research fellow at the Centre for Health Economics at York, said the practice

mirrored what happened under fundholding.

'There is a fear this is what has happened,' he said. 'It may have alerted the Department of Health to get out the correct message.'

GPs rejected the claims as outrageous nonsense.

Dr Chaand Nagpaul, chair of the GPC's commissioning and service development subcommittee, said the suggestion GPs would increase referrals to boost budgets was illogical. 'I don't believe it is happening,' he said. 'The only logical explanation for increased demand is the Government's perverse incentive for secondary care to income generate through Payment by Results.'

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