Downgrading of Referral procedures for GP’s


Under current practice GP’s can refer patients to a large number of surgical procedures. NHSE ( NHS England ) have now given CCG’s( Clinical Commissioning Groups) two lists of procedures which will now not automatically be referred to consultants. Thus, to seek private healthcare for things like haemorrhoids, cataracts, breast reduction and others, patients will have to face a hurdle of restrictions placed on GP’s by the NHSE.
It has been argued that this is a rationalisation process but this is at odds with NHSE’s claims that regional variations in demand are at the root of the process. If so, why the catch all bureaucratic response which threatens to take away the decision making powers of local GP’s in consultation with patients who have their own unique needs. NHSE point out that this initiative is also there to “maximise value” . So at the heart of it this is actually about making cuts. Between 2013 and 2018 the number of people waiting over 18 weeks for elective care surgery grew from 153 000 to 528 000. The NHS is straining to deal with these pressures with inadequate resources.

The Category 2 interventions on their list of procedures which may face the axe is taken directly from McKinsey’s 2009 presentation to the Dept of Health. Remember it was McKinsey which produced the two documents following the 2012 WEF ( World Economic Forum ) conference in Davos, citing model transformations for privatising the NHS. Many CCG’s are already restricting access to treatments of proven value, such as cataracts, and hip and knee surgery. There is also some confusion among GP’s themselves about what treatments are still available. This is value-based rationing.

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