A SCHEME which pays Oxfordshire GPs not to refer patients to hospital is contributing to the £44m financial crisis facing Oxford Radcliffe Hospitals, according to an Oxford MP.

Last month, the ORH Trust announced it was seeking £44m of savings as part of its efficiency plan for 2009-2010.

It is thought £11m of the £44m savings, from an annual budget of £600m, could be made by reducing staff costs, which could lead to the loss of 366 jobs.

But Dr Evan Harris, Liberal Democrat MP for Oxford West and Abingdon, said the GPs’ incentive scheme, introduced by Oxfordshire Primary Care Trust, had placed a further financial burden on the ORH Trust.

Under the scheme, introduced in October last year, up to £1.2m is being handed over in bonuses to Oxfordshire GPs, in a bid to reduce the number of people referred to hospital. Seventy-nine out of the county’s 82 GP practices signed up for the scheme.

Dr Harris said: “I would like to see the scheme scrapped because it is a waste of money, or inappropriate. The drop in referrals is having an impact on the hospitals trust financially because money follows patients.

“Referrals should be made on clinical grounds. It is legitimate to pay doctors to discuss patient cases, but not to pay them to reward them for non-referrals.

“I am not convinced that all patients who should be referred are being referred, and I am not confident that the evaluation to check non-referrals is sufficiently independent of the people taking the money.”

Kidney cancer patient Clive Stone, 61, from Freeland, near Witney, who led a successful campaign to get the cancer drug Sunitinib prescribed on the NHS, said: “I would echo Dr Harris’s call for the scheme to be scrapped.

“A GP could not have found my cancer and it would not have been diagnosed without me being sent to a consultant.

“I would like to know what sort of risk analysis is being done to ensure that early diagnosis for cancer patients, and all patients, is not being missed.”

Oliver Francis, a spokesman for ORH, was unable to reveal the reduction in referrals resulting from the incentive scheme.

But he said: “As part of the normal process by which primary care trusts commission services from hospitals for their local populations, PCTs in Oxfordshire and other areas have told us how many patients they would like us to treat during this financial year.

“This accounts for around a third of our savings plan, and is part of the strategy of PCTs to treat more patients in the community, rather than in hospital.

“While this is done in the interests of patients, it does have an inevitable impact on our income, as it will mean that we will treat fewer patients in some areas.

“The GP incentive scheme is one of the mechanisms that Oxfordshire PCT is using to ensure that the patients who require hospital care get an appointment, and others are treated in the community.”

Sara Price, a spokesman for Oxfordshire PCT, said the incentive scheme was introduced in 2008 following an “unprecedented” rise in the number of referrals.

She added: “The PCT has a finite amount of money to spend on a range of health services. This overspend at our acute hospitals, if unchecked, would have had a negative impact on other health service provision in Oxfordshire, and public health initiatives such as tackling obesity and stopping smoking.

“The scheme was designed to enable us to better understand variations in referrals, to provide opportunities for peer review and shared learning, and to inform service redesign priorities, particularly where we can provide care closer to home for patients.

“Since the inception of the scheme, the PCT would like to make it clear any patient in Oxfordshire who needs a hospital referral will get one.”

Jaquie Pearce-Gervis, a spokesman for the trust’s patient focus group, said: “I welcome Dr Harris’s comments because there was great concern from patients when the incentive scheme was introduced.”