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Patients (Referrals)

Volume 203: debated on Tuesday 4 February 1992

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To ask the Secretary of State for Wales what steps he intends to take to fulfil ministerial assurances that contractual arrangements by health authorities in Wales will not interfere in the freedom of general practitioners and clinicians to refer patients to the most appropriate hospital and consultant.

I shall be issuing consolidated guidance on the management and operation of extra-contractual referrals later this month, and this will again emphasise the principle that GP's and other clinicians should be free, when necessary, to refer in the best interests of their patients.Health authorities when setting contracts and establishing mechanisms for managing extra-contractual referrals are required to have as their objective the pattern of referrals which local clinicians and GPs prefer.From this year, the annual performance review with the Department will he held jointly with district health authorities and family health service authorities so as to further enhance the partnership between primary and secondary care in the setting of contracts.

To ask the Secretary of State for Wales what representations he has received about difficulties and delays experienced when patients are referred by clinicians in Wales for treatment and its transpires that this must be done by means of extra-contractual referral.

The Department has recorded only one representation about delays or difficulties arising from extra-contractual referrals. Upon investigation, I was satisfied that the problems raised by the correspondent were not related to the extra-contractual referral process.

To ask the Secretary of State for Wales if he will make it his policy that all patients in Wales waiting for treatment will be counted in the appropriate Welsh Office statistics; and if he will instruct health authorities that any patients who are described as waiting to go on a waiting list or awaiting extra-contractual referral must be included in that authority's reports and any other published figures.

The monthly returns produced by district health authorities in respect of the treatments they secure for their residents, include statistics for all patients waiting for treatment, whether out-patient, in-patient or day case attendance, across all specialties. Health authorities are required to include extra-contractual referrals in the figures given. They do not operate a system involving people having to wait on one list before being eligible for entry on to another.