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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.

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.

Readers' comments (15)

  • Vinci Ho

    Nigel , you must be famous these days.
    I wonder how many from different political parties are spying on (or even infiltrating) this site and platform everyday?

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  • Vinci Ho

    And what kind of response from GMC is this :
    ‘’GMC said 'any doctor taking part' in a cash-for-cuts referral scheme 'should carefully consider' the GMC's guidance on the topic.’’

    I thought GMC always insist that their ‘first duty’ is to protect the public and hence ,is presumably always on the side of patients . Mr and Mrs superhero??

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  • Vinci Ho

    And NHSE ? Ha ha ha , no f^^^^^g comment, ask CCGs please .
    Poor commissioner from a CCG had to defend something entirely indefensible:
    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.'
    So what is the answer ?
    "How can I help it? How can I help but see what is in front of my eyes? Two and two are four."
    "Sometimes, Sometimes they are five. Sometimes they are three. Sometimes they are all of them at once. You must try harder. It is not easy to become sane.

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  • Why have the GMC not unequivocally damned this idea? Might it be because they long ago became an executive branch of DoH?

    Patients first when it suits them. More faces than Big Ben.

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  • The GMC should really state cash for reducing referrals isn’t acceptable. Period.

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  • Resignation time for those CCG board members involved.
    If not from their own belated professional self respect then they need to be pushed.

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  • GMC are biggest bunch of hypocrites going if they can't clearly condemn this unsafe CCG practice toward patients.
    Instead their usual meally mouthed response which has anything but clarity.
    Time to disband this useless and dangerous bunch of government sycophants.

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  • Why would he say anything this idea has come directly from the 'Top table'.

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  • Pulse Power(less) 50

    21. Health service financial incentives and similar schemes to improve the cost-effective use of medicines have a legitimate role to play in helping to make good use of available resources. Such schemes can also benefit the wider community of patients. But you must consider the safety and needs of the individual patient for whom you prescribe. In particular, you should do the following.

    a. Consider the benefits and risks to the patient whenever you consider changing the patient’s medicine for reasons of cost. One risk, for example, is that patients’ adherence to medicines can be harmed by frequent switching.

    b. Inform patients before changing a medicine and tell them how the medicine should be taken.

    c. Consider what information, explanation and support a patient may need if a new suspected side effect of their medicine is found.

    22. You should follow clinical guidelines and raise concerns5 if you have good reason to think that patient safety is or may be seriously compromised by financial incentives and similar schemes.

    14. If you, or someone close to you, or your employer, has a financial or commercial interest in an organisation providing healthcare such as:

    a pharmaceutical or medical devices company
    a nursing or care home
    a pharmacy or dispensary
    you must not allow that interest to affect the way you prescribe for, advise, treat, refer or commission services for patients. You must be open and honest with your patients about any such interests that could be seen to affect the way you prescribe for, advise, treat, refer or commission services for them.

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  • Pulse Power(less) 50

    GMC Do you require a formal referral of CCG Directors or will you act on your own guidance

    NHS England Will you liase with CCG Directors and forward on any concerns to the GMC

    Jeremy Hunt .. what are you going to do about this
    or will you have the decency to return your award for patient safety

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