Hospital trust climbdown on two-tier list

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The Independent Online
AN OXFORD hospital trust has withdrawn a memorandum to its consultants which said that patients who came from GP fundholding (GPFH) practices should have priority over other patients for hi- tech screening.

The memo from the Magnetic Resonance Imaging (MRI) Department at the Nuffield Orthopaedic Centre also said that non- urgent patients of budget holders would be screened within eight weeks of referral 'which is less than half the time of our present waiting list'. Local doctors complained that this was another example of a 'two- tier' NHS system in which patients were no longer treated equally.

MRI is a non- invasive 'patient friendly' diagnostic technique which gives three- dimensional pictures of the body. Non- urgent cases are likely to be patients with back problems and knee injuries.

Oxfordshire Health Authority, which buys hospital services on behalf of patients from non- fundholding practices and family doctors also protested. It was 'most concerned' over the statement in the memo that: 'Patients on the waiting list who come from GPFH practices should be given some sort of priority'.

David Custerson, health authority secretary, said yesterday: 'It appeared to be unfair to the patients of non- fundholders and we did question it with the hospital.'

Mr Custerson said that after protests the hospital had issued another letter emphasising that the first consideration would be clinical need, regardless of where the patient came from. 'We are much happier with this statement. But there is still a difference in waiting times between the patients of fundholders and non- fundholders,' he said.

Fundholders' patients were seen within about three weeks and non- fundholders within about 18 weeks, he added.

Fundholding GPs are getting millions of pounds worth of treatment free because hospitals are failing to issue them with bills, writes Martyn Halle.

Hospitals are meant to keep records to indicate which of their patients have been sent by fundholding GPs so they can issue invoices. But hard- pressed staff - unfamiliar with the new NHS bureaucracy - frequently fail to make a note. Without the information administrators cannot collect the money.

Some fundholding practices owe hospitals as much as pounds 150,000 in unpaid bills. At one stage a consortium of fundholding practices in Oxfordshire owed as much as pounds 200,000 to local hospitals. In Bristol the Nailsea Health Centre owed its local hospital pounds 150,000; another practice in the city owes a single hospital pounds 100,000.

Hospital managers are now giving fundholding GPs discounts of up to 10 per cent in return for information which will allow bills to be sent out.