Chris - "As has been mentioned above GPs effectively have to pay to refer a patient to a consultant."
The only posters to say that are you in your earlier thread and the repeating of such by fiction-factory above.
"That's because they receive a bonus payment (up to about £11,000 p.a.) for keeping referrals down but that gets cut (by around £100) for each referral they make."
That is not how the bonus works. If you meet your quota you get the bonus; if you fail you receive nothing. Your figures suggest that about 110 referrals would obliterate the bonus. Since the incentive is broadly aimed at reaching a sub-25% referral rate this would mean the practice only has 440 registered patients. The average number of patients per practice in England is about 8,000.
As an example:
A practice with 8,000 registered patients has a quota for fewer than 2,000 referrals to earn a bonus of £10,000 (equivalent to £1.25 per registered patient).
For 1,700 referrals the full bonus is paid - a gain of £1.25 per
For 1,900 referrals the full bonus is paid - a gain of £1.25 per
For 2,100 referrals the bonus is not paid. It is not a cost to the practice other than a loss of a potential gain of £1.25 per registered patient. However, it is 'effectively' the practice either paying £10,000 for all 2,100 referrals (£4.76 per) or for 100 quota-busting referrals (£100 per).
For 2,200 referrals the 'effective' cost is £4.55 per or £50 per (according to how you slice it) but again is really a loss of a potential £1.25 per.