A senior doctor today claims that patients are dying needlessly following major surgery at York District Hospital. That is bound to cause alarm among those waiting for operations.

Consultant anaesthetist Jonathan Wilson would not risk upsetting people without good reason. And his comments must be put in the context of the hospital's excellent record of successful treatment.

Dr Wilson spoke out to draw attention to the shortage, in his eyes, of high dependency and intensive care beds. He believes they play a crucial role both before and after major surgery.

On Saturday, we reported how his pioneering techniques, developed in York with colleague Ian Woods, could cut deaths following surgery by a remarkable 80 per cent. This was achieved by monitoring patients in intensive care or high dependency beds for several hours before their operation.

Today Dr Wilson claims that some patients are not receiving the proper post-surgical attention because of a lack of such beds.

To have a senior medic speak out in such stark terms about survival rates is a concern. North Yorkshire Health Authority has responded by saying that intensive care provision must be viewed not in terms of one hospital, but the county as a whole. On that basis, it believes that there are enough beds to go around.

Intensive care and high dependency beds are expensive. They are staffed continuously by highly trained nurses. The health authority has to make sure there are enough to cover all emergencies, but it cannot afford spare capacity.

The controversy over provision of high dependency beds is the latest development in an ongoing debate about National Health Service resources. While Dr Wilson would like funding for extra beds, more than 1,000 people waiting for a cataract operation at York

District Hospital would want to see any additional money spent on their needs.

By taking a step back from these individual causes, a bigger picture begins to emerge. It is of a hospital that is straining at the seams.

York District Hospital was built in the 1970s. It is now treating many more people than it was designed for, and that figure will rise as pressure to cut waiting lists increases.

Situated in the cramped heart of York, there is little room for expansion. The only way to make room for the much-needed larger car park is to build upwards.

Health Secretary Frank Dobson is championing new super hospitals, built on city outskirts. As York District Hospital struggles to meet mushrooming demand, that is an option worth serious consideration.

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