HEALTH chiefs face dealing with a financial black hole of £86 million this year as they battle to balance their books.

The enormous figure has been revealed in a three-year finance plan released by North Yorkshire and York Primary Care Trust (PCT).

The 59-page document reveals how PCT bosses plan to save £32.6 million between now and April 2008.

Extra cash from the Government is being used to plug part of the £86 million hole - but chiefs still need to work out how to save an extra £15 million to break even by next year.

York GP Dr David Fair, of Jorvik Medical Practice, said further cuts in health spending could not fail to affect patients.

He said: "There's no way of making any cuts which aren't going to impact obviously and detrimentally on patient care.

"There aren't any savings they can make which aren't going to automatically result in patients suffering undue pain and waits for important operations."

The PCT is getting extra cash of nearly £100 million this year - but it is having to use much of that to pay off debts, including last year's expected deficit of £35 million and a further £13 million which is owed to the region's strategic health authority.

There is also an "underlying" debt of £40 million to be taken into account. Nearly eight million pounds will go on meeting Government targets on waiting times.

The PCT has identified different areas of health spending where it plans to save cash, including getting best value out of medicines, and redesigning some services such as dermatology so they are cheaper to run.

There is also a hint that the prior approval panel - which The Press has campaigned against - could be expanded to work out an "exclusions policy" for patients going into hospital for surgery that is deemed "clinically ineffective".

Andrew Waller, Liberal Democrat deputy leader of City of York Council, said local people were paying the price for Government policy.

He said: "The latest financial recovery plan suggests that the NHS funding crisis in York and North Yorkshire will get worse. We are worried there will need to be another £15 million of cuts just to balance the books for this year, even after all the cuts that have already been announced."

York MP Hugh Bayley said the PCT's funding had risen by £20 million since he had forced a debate on the issue in Parliament - and that council leaders were "turning their fire" on the NHS to divert attention from their own record in running the council.

He said: "The £97 million extra is an 11.5 per cent increase which is much more than inflation and the biggest rise in funding that the NHS in North Yorkshire has ever received."


Trust's plans to save cash
Community services and hospitals

Budget: £76 million.

Savings this year: £1.7 million.

How? Making best use of hospitals and staff to make sure they are efficient and only "core work" is done. "Redesigning" the workforce for unscheduled work in the community.

Planned care - eg: hospital surgery

Budget: £262 million.

Savings this year: £10.7 million.

How? Redeveloping some services like dermatology, podiatry, and pain management. Cutting back on follow-up appointments and patients being referred between hospital consultants.

Unplanned care - eg: emergency hospital admissions

Budget: £189 million.

Savings this year: £6.9 million.

How? Supporting more patients in their homes and getting more people with minor ailments treated in primary care, for example by GPs and nurses. Getting patients seen by a senior doctor in hospital before they are admitted.