A scheme that pays GPs bonuses not to refer patients to hospital has come under fire from the British Medical Association (BMA).

Under the scheme operated by some local Primary Care Trusts, GP surgeries are paid cash bonuses of as much as £20,000 if they meet targets to reduce the number of patients whom they refer to hospitals for investigation and treatment.

The Chairman of the BMA's GP committee has said that all referrals should be driven solely by what is in the patient's best interests, and criticises the decision to offer cash incentives to reduce referrals.

The prompt diagnosis and treatment of patients should be the only motivation for all doctors, and so the use of targets and financial incentives to reduce the number of patients being referred for investigation and treatment is a a disturbing idea for doctors and patients alike.