GPs offered payments to send patients private

NHS managers are offering "bribes" to GPs to persuade them to send patients to a private treatment centre instead of local NHS hospitals, it emerged last night.

The unorthodox payments came to light in the primary care trust covering the Leigh constituency of the health minister, Andy Burnham. An investigation by Hospital Doctor magazine found GPs in the area were being paid £30 for every patient sent to Greater Manchester surgical centre, a private unit run by the South African operator Netcare.

Ashton, Leigh and Wigan primary care trust was encouraged by the Department of Health to sign a contract with Netcare guaranteeing a steady supply of NHS patients. The trust will have to pay, even if patients choose to go elsewhere, and so has a financial incentive to encourage use of the Netcare facility.

Last night doctors' leaders protested about the payments. Hamish Meldrum, chairman of the BMA's GPs' committee, said: "We are advising the local medical committee that it would be unwise to accept payments that could be perceived as a financial inducement. If I was to refer a patient to a particular private consultant in return for a fee, I would be up for disciplinary action before the GMC. This may not be quite the same. It is the PCT offering the reward. But there is still a financial incentive to send patients to a particular place," Dr Meldrum said.

The PCT acknowledged making the £30 payments, but denied they were a bribe. It said GPs had to assess patients' suitability for fast-track surgery before making a direct referral to Manchester and this involved extra work. Nearly 400 patients have been treated there and 130 are waiting. "The scheme offers excellent value for money," a spokesman said.

But a Netcare spokesman said: "The Greater Manchester surgical centre does not receive direct referrals from GPs. Netcare is unable to comment on agreements made between a PCT and the GPs in its local health economy."

Dr Rob Barnet, north-west representative on the committee, disputed the PCT's claim that the £30 payment was for extra work. "They say it is for organising x-rays and blood tests, but giving extra money for that doesn't make sense. GPs should be doing that anyway," he said.

Mr Burnham yesterday set new targets for NHS waiting times. He said trusts would have to complete diagnoses within 13 weeks by March 2007, and six weeks by March 2008. By the end of 2008 the entire patient journey from GP referral to treatment should be completed within 18 weeks. The commitment came as NHS trusts in Gloucestershire announced the closure of a network of community hospitals, with the loss of up to 500 jobs.