GPs charging for referral letters

(50 Posts)
NearTheWindmill Tue 18-Feb-14 21:21:22

I'm not sure if I'm being unreasonable but this irks. DD has a problem with an ingrowing toe-nail (quite nasty) and the chiropodist has recommended a general surgeon who is good with kids. We have health insurance. GP happily agreed to refer and has advised there will be a £30 charge for the referral letter.

As far as I am aware the waiting list for this minor procedure on the NHS is pretty long but if dd had to have this done on the NHS the dr would have to write a referral anyway.

It just seems a bit cheeky - and cheekier still that the receptionist told me I can phone tomorrow to see if it's ready. I'd have thought that if I'm being charged, they should be phoning me.

OneUp Tue 18-Feb-14 21:25:17

I don't think it's particularly cheeky. You are basically asking the GP to do you a favour, in a similar way to signing passport documents ect so it seems only fair that they charge a fee.

I can see that it would be annoying though as it's not your fault the waiting list is so long.

So YANB completely U.

That's outrageous. How can he justify charging for it when it means saving the NHS money?

Our GP does not charge for private referrals.

NearTheWindmill Tue 18-Feb-14 21:27:27

But I don't need the GP to sign passport forms - I do need the GP to write the referral otherwise my insurance claim wouldn't be valid. I don't have a choice in the matter and if I didn't have health insurance then neither would the GP who agrees something needs to be done about this surgically.

slowcomputer Tue 18-Feb-14 21:27:30

Charging for a referral letter is unusual, but strictly speaking it isn't an NHS service.GP funding is being stripped to the bone by the government, blame them.

MooMaid Tue 18-Feb-14 21:28:16

My GP told me I was going to be charged but I never was and the receptionist seemed quite bemused.

I also have private medical insurance and have not once paid for a referral letter but I believe they can if they want to, which personally I think is a cheek because I'm freeing up NHS resources elsewhere by going private.

Don't get me wrong, I'm happy with the NHS and would be happy to go NHS but my GP actively encourage you to go private if you can.... probably to free up resources so why the hell pay £30 for a letter!!

Marylou2 Tue 18-Feb-14 21:28:19

This is standard practice at my GP and many others. Mine charges £60.

Weegiemum Tue 18-Feb-14 21:31:02

Charging for a private referral is standard. Why should a GP refer to the private system for free? Perfectly good nhs system available (at least where I live).

Disclaimer: I'm married to a GP who charges. Not for passports or anything else, but always for the private referrals.

Theas18 Tue 18-Feb-14 21:31:21

If its a private referral it isn't part of a GPs NHS "day job" to refer you.

I know it feels odd but GPs are actually only "paid" for NHS services they provide.THey are not employed directly by the NHS. You are asking the GP to do this in their un paid time.

What would you do unpaid? What would a solicitor do un paid ? (nothing!).

It's not saving the GP personally any money that you of privately- yes it might mean the practice notional budget spend is less but that's all.

falulahthecat Tue 18-Feb-14 21:31:33

Whhhaaat?!
I've never heard of this?
Could it be because you're going private? Maybe it's meant to be added to your claim bill?

mousmous Tue 18-Feb-14 21:32:30

it's for a private referral, so that's ok imo.
check if your insurance reimburses, some do.

Sirzy Tue 18-Feb-14 21:32:38

Your wanting the GP to provide something out of the NHS - you are choosing not to use the NHS - so it seems fair enough you pay for it

Ziggyzoom Tue 18-Feb-14 21:32:55

If they charge, will the insurance company pick up the tab?

falulahthecat Tue 18-Feb-14 21:33:12

You generally can't get something on private insurance unless the wait is longer than 8 weeks - at least on ours.
I've never had a GP charge me (directly?) for 3 referrals to a private service.

My GP charges for private referrals. Like you I find it odd, surely going private is reducing the demand on the NHS, and if I were to be treated on the nhs the GP would need to write the same letter.

NearTheWindmill Tue 18-Feb-14 21:35:05

You can't claim it. It isn't the money I object to. I think what irked most was the receptionist telling me I could do the running around to see if it had been done. If I'm charged I think it's reasonable to expect them to contact me. What would your dh think about that weegie.

Also, if we didn't have health cover then a referral would have to be written anyway so I don't see how it takes up more of their time. I am getting less of the NHS resources. It isn't the money I mind, just the principle. And if I'm being charged a private fee, I expect a private service re being advised when the letter's ready.

NearTheWindmill Tue 18-Feb-14 21:36:39

My DH does loads of passports and has never charged for them.

Hotmad Tue 18-Feb-14 21:38:22

That's ridiculous to charge for a private referral, you are actually doing them a favour by not going down the nhs route in which your gp would be charged for! I would point that out to them, speak to the manager if you don't want to question the gp.

Yes, but if the GP refers you to A&E or a NHS consultant then there is a charge made to their practice budget, as are the costs of any prescriptions, are they not. So surely, you are actually saving his budget.....

I agree with charging for passports and travel vaccinations but charging for referral letters is ridiculous. All things like this will do is push more people into using private GPs.

RevoltingPeasant Tue 18-Feb-14 21:39:37

Weegiemum but if the GP will be writing the letter anyhow - as the child needs to be seen, the OP says - why should it make any odds to him whether he writes it to Mr X at his local NHS address, or (ever likely) the same consultant at ShinyPrivateHospital?

Also, I am 100% behind the NHS as an idea but it is silly to say there is a perfectly good system available!

I waited 18mos for a kidney op when I was diagnosed with chronic kidney disease. My DH waited 5 years before the GP would refer him to an andrologist for his ED and painful chronic prostate problems. My close friend's 9mo baby had eczema so badly that she tore her skin off every night and it took them nearly 6mos to get to see a specialist.

If you were in a situation like that, can't you see how you might go private out of desperation??

Ziggyzoom Tue 18-Feb-14 21:40:36

If I had to pay £60 for the letter in addition to the insurance excess, I would be tempted to ask for a free NHS referral and see how long the timescales were once the appointment came through. Children are generally seen quite quickly and if the consultant indicated otherwise I would ask them at that point to treat her privately.

Nocomet Tue 18-Feb-14 21:41:19

I certainly wasn't charged

HarrietSchulenberg Tue 18-Feb-14 21:41:49

So basically you want your GP to spend his NHS paid time writing you a referral letter for private treatment? How is that saving the NHS money?

IamInvisible Tue 18-Feb-14 21:42:09

We had to pay for a letter that DS1 needed for his Army application. We, also, had to do the phoning to see if it was ready. it took bloody ages. It didn't occur to us to get our knickers in a twist!

Musicaltheatremum Tue 18-Feb-14 21:42:35

I don't charge for private referrals but I do charge if I then have to fill in a form for the insurance company so the patient can get their treatment. All these reports we do in our own time as there is no time at all during the day to do them but a referral is different.

horseycoursey Tue 18-Feb-14 21:46:29

Yanbu. My GP charges £35 for a referral. BUPA were horrified by this, as the BUPA form takes two minutes to complete, requires several boxes to be ticked and a signature only. It takes less time than an NHS referral. My surgery GPs are being greedy in charging imo, a letter maybe should be charged, but to tick three or four boxes and sign? Pure greed.

Next time I'll ask for an NHS referral, it'll take the GP longer.

My GP has never charged for private referrals for DS. IMO, she only copies the nhs ones she's written.

Bourdic Tue 18-Feb-14 21:48:03

Can NHS GPs charge their patients for referral or information?
GPs may not charge their NHS patients for private referrals, nor may they charge for the provision of relevant information to other doctors providing care for the patient

Will post reference shortly -it's from the BMA

Paintyfingers Tue 18-Feb-14 21:48:12

Harriet, if it wasn't a private referral they would just be writing exactly the same letter but to an nhs consultant as the referral would still go ahead. So no extra time is spent doing the private referral and public money is saved as the nhs consultant slot can go to another patient.

Paintyfingers Tue 18-Feb-14 21:50:01

Bourdic thanks so much for posting that - we have had to go private for DS ops a few times due to waiting lists and I was shocked to see here that GPS might charge for this.

Bourdic Tue 18-Feb-14 21:52:26

http://bma.org.uk/-/media/files/pdfs/practical%2520advice%2520at%2520work/ethics/interfaceguidanceethicsmay2009.pdf

I am really shocked at some of the responses on here - the GP is behaving completely wrongly and you should make a c

Bourdic Tue 18-Feb-14 21:53:08

make a complaint a

Bourdic Tue 18-Feb-14 21:55:38

bma.org.uk/-/media/files/pdfs/practical%2520advice%2520at%2520work/ethics/interfaceguidanceethicsmay2009.pdf

Sorry- will blue it this time - I am just so outraged by those of you who think this is OK

TheGirlWithTheArabStrap Tue 18-Feb-14 21:57:11

It isn't saving the NHS money to refer patients to the private system. The NHS hospital you would be referred to has its budget based on the number of procedures/referrals it does/gets. If people take their referrals out of the NHS the amount of money the NHS service gets is reduced.

alarkthatcouldpray Tue 18-Feb-14 22:03:05

I have never charged for a private referral nor worked in a practice where it has happened. Seems odd to me.

Paintyfingers Tue 18-Feb-14 22:55:46

By that logic girl, reducing waste in the nhs doesn't save the nhs money as the nhs would just get its budget reduced by the same amount.

The point is that less taxpayers' money is spent.

TheGirlWithTheArabStrap Tue 18-Feb-14 23:08:15

Yes Painty but if we hope to retain a NHS that is free at the point of service and that has any chance of being able to maintain its services to an effective level, it needs money to be spent on it. You can't just magic up doctors and nurses. It just depends if you believe if everyone deserves health care or just those who can afford it.

Helpyourself Tue 18-Feb-14 23:16:08

Is it worth going private windy DD was seen by our GP, referred to the foot clinic and had the operation within a month- and that would have been quicker but we scheduled it for when she had frees and pe.
Or could you not self refer? I've had an operation on BUPA and don't remember by GP referring me, I'm pretty sure I went straight to their dr from the helpline.

divegirl77 Tue 18-Feb-14 23:17:56

I don't charge a fee for private referral letters (as I would be dictating the letter anyway), but I do charge if BUPA etc want me to fill out their forms which I would not otherwise do so and are certainly not included in what the NHS pays me to do. It does actually cost my (and probably most GP's) income directly for every private referral even if only a minimal amount in the cost of a fax or paper, envelope and stamp as the vast majority of my NHS referrals are uploaded electronically.

ibelieveinangels Tue 18-Feb-14 23:19:43

I work in a surgery and we do not charge to do a private referral.

NearTheWindmill Tue 18-Feb-14 23:19:55

But could any of the GPs respond to my point about being the one to chase the letter please. If I pay a fee for the GP to write the letter privately then surely the GP should ensure that his staff call me to let me know the letter is ready rather than the other way round.

I don't know what's right or wrong but I in my heart I feel we are so often told the NHS is on its needs and under resourced that I feel we are being helpful to it to have insurance for treatment we need and for which we have also paid tax to receive but have waived our right to have it. In that case when a referral would have to be written anyway if we accessed NHS treatment I don't really see the logic of the charge but I am happy to pay it if that's what it takes. But having paid for a private letter I do object to being barked at NHS style by the receptionist.

Also, if the practice's admin types the letter, does the Dr pay them a little extra for the private one hmm.

NearTheWindmill Tue 18-Feb-14 23:22:30

helpyourself it's about timing; you are right - not any perception of quality of treatment at all. Also, if the NHS offers an appointment in three weeks, we'd have to say no because we need it to dovetail with school holidays, etc.

NearTheWindmill Tue 18-Feb-14 23:23:31

And we can't self-refer - our policy specifically requires a GP referral. It never used to but it does now.

Helpyourself Tue 18-Feb-14 23:27:09

Aha. Hope you get it sorted soon. Poor Dd had about three courses of antibiotics over a year before we asked for a referral to the foot clinic, then it was plain sailing.

Paintyfingers Tue 18-Feb-14 23:27:27

Girl, I believe passionately in excellent free healthcare.

Unfortunately what we have is free patchy healthcare - sometimes excellent and sometimes downright awful.

I had excellent world class maternity care having DS - wonderful mw and caring, competent staff throughout.

However, I am also sick and tired of having to put right errors in my care - eg my bloods bagged incorrectly using another patient's label which could have left my thyroid under corrected in pg, mc care so poor I had to report to pals and my treatment was the main item discussed at the EPU's internal management meeting. Being told I would have to wait until 15.5 weeks for an ERPC in a pg where mmc was first suspected at 9 weeks was not in the end considered acceptable.

Or the waiting list for ds's ent op where his speech was being very badly affected due to hearing loss? Private care meant he had the op almost 5 months earlier than he would have done on the nhs by the time you factor in the waits for paed audiology, consultant and the surgery. At 2 that is quite significant.

divegirl77 Tue 18-Feb-14 23:27:47

The Practices secretary(s) is employed by the GPs (who are usually self-employed and run a small business) rather than directly by the NHS. We employ them to do what ever secretarial work we want them to do for how ever many hours they are employed, these may be NHS or private letters or insurance reports or invoices for travel imms etc etc. If we need them to do more work than fits into the usual then we would pay them overtime.

In my Practice if someone has asked for a non NHS letter/form etc for which we are charging then our reception team would call when it is ready (however this be later the same day or even the next day depending on how busy they are with other things).

NearTheWindmill Tue 18-Feb-14 23:32:53

I'm glad to hear that divergirl77 because what irritated me much more than the charge was the response to my "when will it be ready?" which was "I dunno, phone up tomorrow after 2 and see if it's done".

macdoodle Tue 18-Feb-14 23:40:47

I think you're being ridiculous.

fivefourtime Wed 19-Feb-14 04:43:25

If it's paperwork they have to do for non-NHS related stuff then it's only fair that they charge, I'm afraid! I do agree with the person who said that it sucks that the waiting lists are long enough for you to have to go private, but I would still be happy to fork out in this case.

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