SEVEN emergency patients a day could be turned away from York Hospital's casualty department from as early as next month.

The shocking figure has emerged as the hospital prepares to axe nearly 100 beds, blaming a cut in income of £4 million from the cash-strapped North Yorkshire and York Primary Care Trust (PCT).

That means 50 patients a week could find themselves unable to get a bed at the hospital when they are urgently sent there.

Instead, they will have to be taken to hospital in Leeds, Harrogate or Scarborough - up to 50 miles away.

York Hospital nursing director Mike Proctor said the change could start as early as May.

He said: "There's no doubt that some of the patients who are currently sent to hospital could be cared for in the community. I'm sure the PCT is confident it will be able to make provision for those patients within the community.

"It is important GPs have decent alternatives to manage these patients. The issue is that the PCT's job is to commission services from us, and we have got a contract agreed with the PCT which identifies a reduction in the number of patients who are going to be sent to us. There's a reduction in income coming to the hospital, we have therefore had to cut our capacity and our costs."

Mr Proctor said last year, the hospital's casualty department saw 550 emergency patients a week. But this year, the PCT were only prepared to pay for 500.

Hospital bosses have always stressed that patients whose condition is life-threatening - for example, if they are having a heart attack - will always get a bed in York. However, other patients who are sent to hospital, but whose lives are not in danger could end up being victims of the cut-backs.

The hospital plans to introduce a system so that it can contact GPs and the ambulance service when no more beds are free.

Glen Gears, York ambulance service's Unison representative, said: "It potentially means there will be a reduction in ambulance cover in York because we'll be travelling and spending our time in other areas, travelling to Leeds or whatever hospital.

"If we're not around and there's a life-threatening case to respond to, because we're running back and forward to Leeds and we're not in York we could be hours away. That's a really, really dangerous situation."

A spokesman for the PCT said "substantial investment" was being developed in changing how patients were cared for - which would mean more would be treated closer to home and not in hospital.

He said: "An example of this service modernisation work is how, together with the Yorkshire Ambulance Service, we are looking at developing new ways of dealing with emergency calls to the ambulance service, with the aim of enabling call handlers to identify the most appropriate service for those patients who phone 999, but who don't require accident and emergency care.

"This means that non-urgent calls can be re-directed to a more appropriate service more efficiently, ensuring that patients can see the most appropriate professional for their needs, reducing unnecessary visits to A&E and enabling the ambulance service to concentrate resources on the most urgent cases."

Changes on the cards...

SUBSTANTIAL changes in health care are on the cards this year as the PCT prepares to turn its fortunes around.

The organisation has announced a major strategy for clawing back debts which have been accruing for several years.

It is estimated it will have ended last year with a debt of £35 million, which will have to be repaid.

Savings of £33 million are planned for this year, with proposals to cut back another £15 million.

The Government has increased funding to the PCT by nearly £100 million this year, and much of that is being used to pay back debts and reduce waiting lists to meet Department of Health targets.

The PCT is planning a wide range of strategies to save money, which mainly concentrate on treating fewer patients in hospital.

York Hospital has announced it will have to shed another 200 jobs and lose 95 beds this year because of a cut in income from the PCT. It will mean treating 10,000 fewer patients a year - including those who come in for surgery.