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Market-oriented changes within the NHS in the last 15 years have increasingly created difficulties with funding of referrals to tertiary psychotherapy health providers. The often-cumbersome, time-consuming and expensive bureaucratic procedures now required by the Primary Care Trusts to fund patients referred to tertiary care services leads to lengthy delays in the pathway from assessment to treatment. This paper describes a systematic survey of funding and administrative delays endured by the 23 patients referred on a cost-per-case basis to the Outreach Personality Disorder service at the Cassel Hospital over a 1-year period. The results of the survey found that the median administrative delay patients endured between referral to treatment funding decision was 141 days. Two cases are presented to illustrate the difficulties encountered by patients who have to go through several obstacles before they can obtain the treatment they need. The implications of NHS reforms for the future of socialized healthcare in general and for psychotherapy tertiary care service provision in particular are highlighted in the discussion.