Health services in York and North Yorkshire today received a £27 million cash boost.

But local health chiefs were warned some of this extra money depends on them meeting tough performance targets.

Health Secretary Alan Milburn detailed how £660 million of the extra £2 billion for the NHS announced in the Budget would be allocated.

Sixty million pounds is being held back for the incentive scheme to encourage poor-performing hospitals and groups of family doctors to improve services.

North Yorkshire Health Authority will receive £474,576,000 for the 2000/01 financial year.

This is a real terms increase of £26,912,000, or 6.17 per cent, in total. As part of that total, a proportion of £9,205,000 will be allocated from the £660 million fund announced in the Budget.

However, this proportion of more than £9 million will depend on health chiefs achieving the targets.

A referee-style red card system is being brought in to warn failing hospitals and staff.

Apart from these warnings to underperformers, ministers are to set targets for reducing waiting times, making preparations to avoid a winter flu crisis and stabilising finances.

Malcolm Palmer, chief officer with the York Community Health Council, said he hoped the money would go directly to help people with the most need in hospitals.

He said: "All the additional resources provided by the Government will be very welcome from a patient's point of view. We are very confident that the York NHS Trust will put the money to the best possible use.

"We would rather see the money being spent in ways which will help people with the greatest need rather than to meet number-crunching target figures which would not help individuals."

Simon Pleydell, chief executive of York NHS Trust, said that if the Budget boost meant real-terms growth for the NHS then it was very good news for the York trust.

But if hospitals continued to fail to meet standards, specialist NHS management teams would be sent in to turn them around.

Health Minister John Denham said: "We are determined to ensure these resources do deliver real services and not red tape.

"For the first time ever the Secretary of State is going to use his powers to direct that resources must be used for frontline services and not be held back by health authorities."

Mr Milburn will instruct health authorities to pass the extra money to Primary Care Groups - GPs - which commission services from hospitals.

The incentive cash will be allocated in quarterly £15 million tranches which will aim to end the "postcode lottery" of health care services.

Trusts that fail to meet the targets but improve their performance later will be able to reclaim the performance-related bonuses.

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