§ Mr. SpearingTo ask the Secretary of State for Health what current regulatory or administrative constraints prevent general practitioners contracted to the National Health Service from referring a patient to any unit of that service; and what constraints will be, or are likely to be, placed on such general practitioners not opting for budgeted practice status, after implementation of the proposals described by Cm. 555 "Working for Patients", and related consultation papers and statements.
§ Mr. Mellor[holding answer 19 October 1989]: In principle, GPs currently are free to refer their patients to any unit in the National Health Service, the decision whether or not to accept a referral being a matter for the clinical judgment of the consultant. However, the choices open to GPs may be constrained in practice, for example if the preferred hospital is a victim of its own success and cannot accept additional patients because of budgetary constraints. Our proposals to enable money to follow patients are designed to overcome such problems. The future arrangements for securing GPs rights of referral are described in paragraphs 3.5–3.16 of the recently issued "Contracts for Health Services: Operational principles" copies of which are in the Library.