. There is no access to tertiary hospital in NWP, referrals to Gauteng Province tertiary hospitals is very difficulty especially Dr George Mukhari Hospital and Steve Biko Academic Hospital. Gauteng Province and the tertiary hospitals have a contract with NDOH that as beneficiaries of the National Tertiary Services Grant they are to provide listed tertiary services. More than R2.3 million has been allocated to the hospital for this purpose. Dr Moagi noted that this information may not be known to the clinicians and specialists who are denying patients this access and perhaps administrators with this information should ensure that it filters to all clinicians and that all comply.