"Making a referral letter available"

I have a  difficulty with my right knee.  I self-referred to the Physiotherapy Service in the Southern Trust, Northern Ireland.  After a number of sessions of Physio I was referred to ICATS Southern Trust.  I was triaged by ICATS and placed on a list to see an Orhtopaedics surgeon - I was advised by the Booking Service that the wait time was over 3  years.

I am a member of Benenden Health, so I requested their service in view of the lengthy wait time.  Benenden requested a copy of my referral letter.  I requested a copy from the Physiotherapist Service (which referred me).  I was told that they couldn't make a copy available to me; instead I should approach my GP.  I was advised by my GP Surgery that they didn't have a copy of the referral letter.  I then approached the Booking Service and was told they couldn't make a copy available.  ICATS agreed to provide a copy by email to my GP; they weren't free to issue me with a copy.  On contacting my GP Surgery I was told they hadn't received a copy.

At this point I was fully frustrated and sent an email to my GP.  In the email I outlined my difficulty and pleaded for their support.

I received a prompt confirmation by telephone from the Surgery that a Referral Letter was available for collection.

It is clear from the detail in this letter that the Doctor issuing it did not have sight of the original referral letter from the Physiotherapy Service - this GP referral was based on the results of an XRay, which had been requested by Physiotherpy after my first visit there, and also based on the information I had provided in my email to my GP.  Notwithstanding the lack of specific detail, which I presume would have been in the original referral letter, Benenden took action and referred me for Assessment/Diagnostics.

I fail to understand why my Physiotherapist could not have provided me with a copy of the original referral letter.  The explanation given to me was that to do that would have constituted a direct referral to private healthcare.  Again, I fail to understand how making available a copy of a referral to ICATS (evidence of a referral within the NHS) can be viewed as a referral to private healthcare.  Secondly, it would have been helpful if a copy of the original referral letter from the Physiothery Service had been made available to my GP.

I understand that the rationale for both the introduction of Self Referral to Physiotherapy on the one hand and the establishment of ICATS was to lessen the workload of GPs.  That doesn't appear to have been the outcome in my case.