Doctors have criticised the increasing interference in the way patients are referred for surgery.

Over half of English GPs are being forced to use referral management centres which have been rolled out over the last two years.
The centres act as "middle-men" between GPs and hospitals by recommending where and when patients are treated.
But the British Medical Association said they were being used to ration care and create unnecessary red-tape.

The centres are manned by primary care trust staff, some of whom are not medically qualified.

A recent survey by doctor's magazine Pulse found 53% of GPs were having to use them to refer patients to hospital - in many of these cases they were being barred from naming the consultant they wanted their patient to see.
The centres tend to handle GP referrals for musculoskeletal, ophthalmology and neurology treatment rather than cancer care and more urgent conditions.

Dr Hamish Meldrum, chairman of the BMA's GPs committee, said: "There is considerable concern among doctors, both GPs and hospital consultants, about referral management and related arrangements.
"Models vary across the country, but diverting GP to consultant referrals to a referral management centre seems to be increasingly common."

The BMA has been canvassing opinion among their members about the referrals.

'Working well'
Dr Meldrum added: "Where local clinicians have been consulted and involved in designing the schemes, things may be working well.

"In other places there has been no effective consultation and it seems the main intention is to cut costs either by trying to limit referrals or by delaying them.

"NHS trusts are telling GPs that non-urgent cases will not be treated until they have reached the maximum waiting time permitted within government targets.

"This is not acceptable and is potentially harmful to patients' health."
But a spokesman for the Department of Health said: "Referral management schemes should ensure NHS patients see the most appropriate clinician in the most convenient setting.

"These schemes must only be set up where they will benefit patients."

"The department has issued a wealth of guidance to ensure this message gets through to the NHS and trusts should be reviewing existing schemes to ensure they create put the patient first.

"If a patient needs to be referred to hospital then, clearly, they should be referred. "

"However, dealing with some referrals outside of large hospitals can relieve pressure on the NHS, provide more convenient care for patients, and deliver better value for money for the taxpayer."

Credit |BBC Health News: Click here for article.