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how does the UK budget restriction on Primary Care Physicians/ general practice doctors work? is it that they only have $x to allocate to all the tests they give to a single patient and if they use some portion of it on an OSA test, they have less money to allocate to testing for other disorders?  i'm not aiming to knock that system.  just trying to understand it.

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Yes, they do have a budget, but as far as I know it's not allocated per patient, it's per GP Practice and they have to answer to the PCT (Primary Care Trust) as to what drugs etc. they can spend the money on. However, this is due to change and it is expected GP's will be in charge of their own budgets.

If a person goes to their family GP with suspected OSA and that GP doesn't agree with the patient or lacks knowledge on OSA, then they can decide not to refer them to an ENT or Chest Specialist to see if they need a sleep test. If their GP has a number of other GP's working in the practice they can see a different one and hope that GP agrees with them. However, some GP Practices are run by only one GP, so the person would have to change to a different GP or look for a private sleep test.

I'm sure there are pros and cons for both our different country's healthcare systems.

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