Hunt must abolish 'unacceptable' cash-for-cuts GP referral schemes, says Labour

The Labour Party has called on the health secretary to address Parliament to ‘rule out’ the ‘cash for cuts’-style GP referral schemes revealed by Pulse today.

Shadow health secretary Jonathan Ashworth raised Pulse’s much-publicised investigation – which unveiled cash incentives to GPs for cutting referrals, including for suspected cancer – in the House of Commons on Wednesday.

It comes as Pulse’s investigation also sparked condemnation from GP leaders, caution from the GMC, and harsh criticism from commissioning leaders.

How the ‘cash for cuts’ referral schemes work

Mr Ashworth said: ‘In today’s newspapers we have learnt that some CCGs are offering cash incentives for GPs not to refer patients to hospitals, including cancer patients. We believe that this is totally unacceptable.

‘Has the secretary of state for health given you any notice that he intends to come to the House to make a statement, to tell us how extensive this scheme is, and so that we can call upon the secretary of state to rule out this unacceptable practice?’

Speaker John Bercow responded that Mr Hunt has not asked to make a statement but that Labour was free to continue to raise the topic until there was a ministerial response.

On Twitter, Mr Ashworth said: ‘Some might call these “bribes” – health bosses offering cash incentives to doctors not to refer patients to hospitals. Ministers should block this unacceptable scheme now.’

He added that doctors were given ‘cash to cut cancer referrals too’, and said ‘ministers urgently need to intervene and halt this’.

Also commenting on Pulse’s investigation, the GMC said ‘any doctor taking part’ in a cash-for-cuts referral scheme ‘should carefully consider’ the GMC’s guidance on the topic.

A spokesperson said: ‘Good Medical Practice is clear that decisions about clinical care must always put the patient’s interests first. If a doctor does have concerns about a scheme, they should raise their concerns through the appropriate local and national channels.’

NHS England declined to comment, with a spokesperson telling Pulse that the questions were for CCGs to answer.

But NHS Clinical Commissioners co-chair Dr Amanda Doyle, also chief clinical officer at NHS Blackpool CCG, said that ‘directly linking payments to reductions is not appropriate and NHS England, as the regulator, would take a role in addressing that circumstance’.

She added: ‘Ensuring patients get the best possible care against a backdrop of increasingly squeezed finances is one of the biggest issues CCGs face, but we know that clinical commissioners are working hard to improve local services by making responsible, clinically led decisions in partnership with GPs, patients and providers.’

RCGP chair Professor Helen Stokes-Lampard went further, arguing that the schemes were ‘insulting’ to GPs.

She said: ‘It’s high time for commissioners to appreciate that GPs are highly-trained medical professionals, who know our patients, and will act in the best interests of their health and wellbeing…

‘Cash incentives based on how many referrals GPs make have no place in the NHS, and frankly, it is insulting to suggest otherwise.’

Her comments come as the RCGP called for referral management centres focused on making savings to be scrapped earlier this week.

Pulse also understands that political campaign group 38 Degrees is considering launching a public petition against cash-for-cuts referral management schemes.

The news today that some CCGs are offering cash incentives to GPs to cut patient referrals to hospitals – including cancer referrals – is totally unacceptable. We’re calling on minister to intervene and block this practice. Patients deserve better. pic.twitter.com/Se2Czbmmob
— Jonathan Ashworth (@JonAshworth) February 28, 2018