SENIOR members of North Yorkshire and York Primary Care Trust (PCT) were quizzed yesterday about the future of health services in the city and wider area.

Around 70 people, both individuals and representatives of various organisations, were at the meeting organised by City of York Council's scrutiny of health committee.

The PCT is currently £45 million in debt and this money needs to be clawed back.

Many of the questions asked about the future of particular NHS services were met with the answer that alternative delivery methods may be available which are more cost-effective and of greater benefit to the patient.

Dr Steve Crane, an Accident and Emergency (A&E) consultant at York Hospital, said he had been told by the PCT that a new system of assessing patients' need would be in place by February 5 - just four days away - and that there had been no consultation.

Janet Probert, operations director at the PCT, admitted that time-scale was now highly unlikely.

She added A&E departments in York, Harrogate and Scarborough were now busier than ever and the PCT must pay for every patient treated by an acute hospital like York.

In addition Dr David Geddes, the PCT's medical director, said the more money spent on A&E, the less money is available for people with chronic diseases.

When it came to the Prior Approval Panel, which The Press has started a campaign to scrap, audience member Sandra Geere said she had always been happy to trust her doctor about the care she should receive.

Dr Geddes replied that the panels are about making sure the budget is spent in the most appropriate way.

He said: "GPs have always been involved in a process of prioritising. Not all patients get the most expensive drug.

"What we need to be addressing is a commissioning threshold - we can afford to treat bunions at this level if they are causing people pain and difficulty in walking, but not if they can't get their shoes on."

However, a retired surgeon in the audience described the Prior Approval Panels as "rationing".

Several complaints were also heard from the voluntary sector about the renewal of contracts.