Exclusive: Services axed as care trust battles huge debt

Health chiefs in North Yorkshire say immediate action must be taken to slash spending on services for 800,000 people.

No new patients will be offered IVF "test tube baby" treatment, minor surgery at GP clinics will be stopped, non-urgent hospital treatment delayed and voluntary sector groups face cash cuts as part of an urgent range of money-saving measures. Sixty NHS managers are also being made redundant.

The crisis is the latest to hit the NHS in North Yorkshire, after being beset by financial difficulties for years.

Plans for savings of 25m during 2010-11 have had little success as demand for care has continued to rise, leading to warnings the county's primary care trust (PCT) will be unable to pay bills by March unless it makes immediate cuts.

The move comes as an Audit Commission report warns of a "significant ongoing risk" to the PCT which faces "difficult decisions over the level and range of services".

Managers say future changes will lead to fewer people being treated in hospital and more care in the community – reflected in today's controversial closure of two wards at Malton and Whitby hospitals.

The MP for Thirsk, Malton and Filey, Anne McIntosh, said: "This is another example of financial incompetence on the part of the PCT. It has spent 1m refurbishing Ryedale ward at Malton Hospital, only to close it six months after its reopening.

"Clearly those living across North Yorkshire will be deeply concerned and disappointed at further reductions in services."

The chief executive of Infertility Network UK, Clare Lewis-Jones, said the decision to axe IVF treatment came just months after the trust ended restrictions on treatment only to women in the six months before they were 40.

She added: "On behalf of patients in North Yorkshire, words cannot express how angry and let down we feel about their decision to suspend funding for IVF treatment.

"PCTs simply cannot play around with people's lives and futures like this by stopping and starting funding.

"The physical and emotional impact of infertility is enormous and this just adds to it."

Boroughbridge family doctor John Crompton, chairman of North Yorkshire's Local Medical Committee of GPs, said the health service in the county received 12.5 per cent less funding per head than the average in Yorkshire.

The latest measures were short term but what was needed was a long-term plan to drive change and reshape services.

"We recognise the national financial climate but we are browbeaten here every year to deliver more cuts and efficiencies than most other places and we are reaching the end of the line in terms of the efficiencies we can make," he said.

Latest figures show the PCT, which has a budget of 1.3bn, was nearly 18m overspent in the six months to September which would translate to a deficit of 29m by March or a worst case of 51m. It had an underlying deficit of 18m last year, while Harrogate and York hospitals also agreed to waive payments of 6m for services.

PCT chief executive Jayne Brown said the decisions were "unpalatable" but she added: "Nobody should be in any doubt as to the seriousness of the challenges we are facing. We need to take action immediately.

"This means making hard decisions to protect services for the majority."

Immediate action includes:

IVF procedures halted from January. Anyone on waiting lists will be treated but no new patents will be added unless in exceptional circumstances. The decision will hit around 250 couples a year, saving 1m.

Cutting drug bills by reducing prescribing of branded medicines.

Cuts of 150,000 from January in funding for 18 voluntary sector organisations.

Stopping routine procedures such as minor surgery and

some diagnostic tests in GP practices and providing them in hospital.

Cuts in running the PCT including the loss of 60 posts.

Waiting times for non-urgent treatments extended towards the maximum of 18 weeks.

In her 2009-10 report, district auditor Lynne Snowball said the PCT did not have proper arrangements in place to "secure economy, efficiency

and effectiveness" in using resources.

She added: "In the light of the economic downturn and the related pressure on public sector finances, the PCT faces a significant challenge in meeting the needs of the population within available resources in the medium term."

Savings would be required at a time of massive management upheaval as the PCT's responsibilities were shifted to GPs.

"This represents an unprecedented challenge," she said.