This is a matter for the medical profession in the first instance. The Medical Council as regulator of the medical profession is responsible for the Guide to Professional Conduct and Ethics for Registered Practitioners. Section sixty of the Guide sets out best practice in patient referral and in summary states that it is in the best interests of a patient that a general practitioner supervises and guides the overall management of their health. It goes on to say that where a Consultant sees a patient in the absence of a G.P. referral letter the patient’s general practitioner should be kept informed of the patients progress, unless the patient specifically objects to this.