The government are keen to reduce waiting lists by preventing (or discouraging) referrals.
This is a true story.
A lady went to her GP with a lesion on her face which had grown over the course of a year. The GP said that it was a mole, and that it could not be removed because it was cosmetic. She went away but went back to the surgery to say that it had grown and bled. The GP wrote to a plastic surgeon, who said that he could not see her as he was not allowed to see benign moles.
The patient was still concerned so the GP wrote to the PCT exceptional cases committee asking permission for her to see a specialist. The PCT said that she could only be referred if she was sent to a clinical psychologist who was to determine whether the lesion was causing her distress. She saw a psychologist, who asked all sorts of personal and embarrassing questions and finally recommended specialist referral; so six months after she was originally seen by the GP she was sent to me for my opinion.
On examination the lesion was not a benign mole, it was not a simple cosmetic problem, it was a large skin cancer, which I shall excise.as a matter of some urgency.
It's enough to make you weep.