Paying for referral letters from GP?

[summerbreezer]

Hi all,

I have recently been referred by my GP for some treatment with a psychologist. As I have private health care through work, I have found my own professional. However the insurance company asked that I get my referral letter from my GP before they will authorise the work.

I attended a week ago for the appointment and have just returned to pick up the letter, only to be told by the bloody rude receptionist there is a £25 fee!

When I asked for the reasons, they said that it was because it was private rather than NHS treatment. I find this confusing as I saw my GP on the NHS.

Has anyone else had any experience of this? I am thinking of complaining to the Practice Manager and asking for the reasoning behind the imposition of the fee. Unless of course this is a universal practice and I am just kicking up a fuss over nothing.

Thanks in advance!

[curvyredmug]

You're not paying for the referral letter, you are paying for the extra paperwork to do with the insurance company. If you were self paying for the private appointment and just needed the letter there would be no charge.

This extra administrative work is not funded by the NHS and it's completely standard for it to carry a fee, the same as letters for lawyers, work, schools, housing etc. NHS GPs are on their knees with overwork and just do not have time for this sort of thing unless it is funded.

(have you guessed yet that I'm a GP!)

[summerbreezer]

Hi curvyred, thank you for your reply. I completely understand that any additional work over and above the usual role of GP should be paid for.

I have checked with the insurance company and they don't require the letter - just confirmation (which they seem willing to accept from me orally) that the GP has considered me suitable for referral.

The only person who has asked for the letter is the psychologist, but even she is not that bothered as she does her own assessment anyway.

Surely if I was to see a consultant on the NHS then exactly the same referral letter would need to be written to "introduce" me to the consultant etc.

I am not saying you are wrong (I am sure you are right, but I am still a bit confused!)

[Groovee]

Anything out with a GP's work is usually charged for as its gets done in the GP's own time. Our surgery has it on its website and signs around the surgery.

[eedon]

I've never paid a fee, all the letters ive needed they've scribbled during an appointment.

25 is cheap though. I think everyone should pay this just to see a gp.

[RealHuman]

I don't think they're allowed to charge for a referral but as mug said they charge for the other paperwork.

[Tiggeryoubastard]

You're not being charged for a letter to refer you. The charge is for a copy. To include the time and goods used to produce said copy. Why should the NHS pay for that?

[curvyredmug]

There is still extra work - you've presumably had conversations with the GP/secretaries to clarify what you need (because you initially asked for a copy of the letter, now you don't need it). Also, many private referrals are done that just wouldn't be done on the NHS, so it all adds to the workload. I know it seems harsh but if you think it's bad now wait until the government tries to magic up 7 day 12 hour opening out of pixie dust and fairies!

[whois]

Yeah it's standard to pay for a private referral letter.

[2rebecca]

My GP doesn't charge for private referrals if they would have done a referral on the NHS any way as it's no extra work to dictating and typing an NHS letter

[PsychologicalSaline]

I received a private referral from my GP back in July. She kindly sorted the referral letter and which consultants would be valid under the insurance in my appointment time. No fee. As above poster mentions the referral would have been on NHS anyway so no extra work to bill for surely?

[MinecraftWonder]

I also think it's very 'unfair' for this to be charged.

If a referral is needed then it would be needed regardless of who the referral goes to. All you/your company are doing is saving the NHS the cost of carrying out the actual treatment - which surely is a good thing and should be encouraged rather than charged for.

A friend of mine recently needed a referral for additional treatment and as she has private health cover from her work, asked for the open referral so that she could find her own consultant privately. Much quicker for the patient (pretty instant treatment rather than a 3 month NHS wait) and saving the NHS the cost of treatment.

The NHS GP argued black and blue with her that she would rather do the referral through the NHS, and only reluctantly provided the (free) referral letter after my friend insisted. I don't get it personally - surely the more stress taken off the NHS the better.

[summerbreezer]

I agree completely Minecraft. That is what I am failing to understand here.

All the additional work is done by the psychologist - she is having to do various reports etc for the insurance company. The GP is just doing what the GP was doing if I was going via the NHS. They do not even know the name of the psychologist.

I understand that doctors have huge work and time pressures, and I completely understand the concept of paying for anything above or beyond that. But I would have got this referral on the NHS - so I really don't understand the fee!

[IKnowIAmButWhatAreYou]

The charge is for a copy. To include the time and goods used to produce said copy. Why should the NHS pay for that?

Actually, last couple of times I've been referred, I've gone to the doctors with whatever ailment it is & when we get to the end of the session I pass him the letter to sign.

BUPA give me a letter that the doctor just has to write the reason for referral on and sign.

Not the end of the world!! Funnily enough, the Doctor signs it & I "forget" to stop at reception to pay.

Given that the treatment & subsequent appointments are removed from the NHS, freeing them up for those without cover I think it's a shame they feel they have to charge.

Personally I'd rather they charged for missed appointments.....

[curvyredmug]

If I do a chargeable letter I always take the patient out to reception myself so they don't 'forget' to pay! Lots of private referrals are not strictly necessary so it is quite a heavy workload overall.

[littledrummergirl]

You could have paid your GP for a private consultation and paid £50 for your appt if you were intending to go private. You asked for a letter to be written that is outside of the NHS service, it's entirely reasonable that you pay for that.

[saucony]

If I have a health problem that would meet criteria for NHS referral, I'd be a bit at having to pay for a private referral letter.

[KitKat1985]

I think it's fairly standard to have to pay for referral letters for NHS organisations. A consultant at our hospital used to charge £150 to deal with non-NHS paperwork.

[Arsicles]

its gets done in the GP's own time

It didn't in the surgery I used to work in, and that did annoy me. The GPs did all private stuff during their NHS working day, even blocking out much needed NHS appointments to do it. This wouldn't even have been so bad if the private fees were ploughed back into the surgery but they weren't, they went straight to the GPs. Not saying all GPs do this, and I know they're overworked etc, but I have seen it done like this, and meetings held to see how many things could be charged for and how much we could get away with charging. It was wrong.

[Cornettoninja]

Strictly speaking no nhs resources should be used for private work. The secretary, stationery, equipment are all off limits. I'd wager that there's a pretty good argument for an initial private gp appointment if that's your intention from the beginning. Should an nhs appointment be used to make a private company money for instance?

No clinician is under any obligation to agree to document and put their professinal name to anything so they're more than entitled to insist on a face to face appointment before agreeing. Clinically they may have very valid reasons for not agreeing.

You are certainly saving the nhs money, but it also means that there's no accountability for the resources you have used. It all counts in a service digging out pennies from the back of a sofa.

There are pretty strict guidelines about keeping nhs and private seperate.

[eedon]

Do the doctors pocket this money?

I'm never sure how private work works in the NHS.

[Cornettoninja]

Essentially eedon. Most gp practices are private companies so there's probably a system set up for the any cash to go through their accounts with a certain amount payable to the doctor. Most GP's (from my understanding) are self employed or not directly employed under the nhs. I've certainly heard enough of them moaning talking about the end of tax year paper work.

Happy to be corrected though

[BetaTest]

I understand the reason why the GPs charge for a letter HOWEVER it should also be recognised that the NHS is saving money by you going private.

My bigger concern is that doctors/consultants working for the NHS flit between NHS and private from one minute to the next sitting in the same chair or standing in the same operating theatre.

My Ds had an ear operation done privately but in reality he just got bolted on the end of the NHS operations done that day by the same surgeon.

I was not happy that what the consultant had effectively done was boot someone off the NHS list so she could do the operation privately on my DS. She literally didn't leave the operating theatre as the NHS patient was wheeled out and DS wheeled in.

My feeling is doctors/consultant should either be 100 % NHS or 100% private. There is a potential real conflict of interest where a consultant is able to offer both NHS and private treatment. This is especially the case where a patient is in pain because a patient seeing a consultant could be persuaded/pressured to go private if the consultant delays the operation long enough.

[eedon]

Ah thanks for that. The NHS system baffels me tbh.

I found out recently that a friend earns the same as me (10k a working day) and she's been a gp for 10+ years. Apparently the practice is run like a business, but to earn serious money you have to be a partner and that involves lots more work. I thought GPS were all on 100k + previously!

[eedon]

I was not happy that what the consultant had effectively done was boot someone off the NHS list so she could do the operation privately

I think that is a myth. If you hadn't of taken the appointment then it would of just gone unused and not passed on to an NHS patient. There was a thread a while ago about this.