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Last Updated: Wednesday, 3 January 2007, 10:39 GMT
Controversy over child referrals
By Graham Satchell
BBC News

The NHS in Milton Keynes is in debt - by 18m at the last count.
Sick child
GPs are concerned the initiative could put children at risk

Like many health authorities across the country, it's trying to save money.

But the way it's doing it is proving controversial.

GP's here have been sent a letter detailing the cost of referring children to the local hospital.

It asks whether any of this could be done more cost effectively.

The letter says the trust spent 1.5 million referring children to the local hospital last year

It points out that 79% were discharged within a day and goes on to say "this area of activity was one which was likely to achieve cost savings"

'Value for money'

The letter has horrified local GP Eric Rose.

I think it's potentially dangerous
Dr Eric Rose, GP

For him it's a veiled threat to doctors to think twice before sending sick children to hospital.

Dr Rose says: "I think if you're fairly new to the job, you're impressionable, you're given the impression that you're referring unreasonably - you might think again."

"I think it's potentially dangerous. It would only take one child that should go to hospital not to be sent to hospital and for there to be a tragedy and I think there would be a lot of questions asked."

Parents at a local toddlers group were concerned. They thought a child should see a specialist if it was sick - and that money should not be a factor.

There are now fixed prices across the NHS for treating patients in hospital and health bosses in Milton Keynes think the local hospital is charging too much to see children.

But Dr Nicholas Hicks of Milton Keynes Primary Care Trust said this was "categorically" not about telling GP's they shouldn't send sick children to hospital.

"What it's about is trying to help GP's understand the costs of the treatment that's provided in the hospital - and provide them with the information to make a judgement as to whether that represents good value for money."


The trouble is this isn't the first time local doctors have been given "information" about the cost of treatment.

This time last year, GP's got another letter talking about major financial problems and asking them to save money - the letter spelt out "six quick wins" to help the local NHS live within its resources.

For example, the letter says sending a patient to the local surgical unit costs 822

It goes on to say that admission to Accident and Emergency "is about seven times cheaper"

Health bosses say it's important for GP's to understand the cost of treatments and know the alternatives outside hospital.

GPs say they feel under pressure to compromise patient care.

How one patient got caught in the GP referrals system


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