CONTROVERSIAL new health proposals restricting hospital referrals across North Yorkshire have been heavily criticised by a leading doctors' group.

York Health Group - a GP body which has a say in how NHS cash is spent in the York area - said it was "bitterly disappointed" by a document from health chiefs which restricts doctors' ability to refer patients to hospital.

We exclusively revealed yesterday how the proposals set out which patients should be referred to hospital for a range of operations like hip and knee replacements.

One doctor branded the proposals "health rationing" - saying some patients would have to be virtually housebound before they got to hospital. Now members of the York Health Group said they "rejected" the document - although they supported the principle behind reviewing health care delivery.

Chairman Dr David Hartley, a GP at Jorvik Medical Practice, said the group had tried to talk to Selby and York Primary Care Trust (PCT) about how patients should be treated, but had made "little progress".

He said: "York Health Group is therefore bitterly disappointed by the unilateral imposition of this document without any local primary care clinical input. No local GPs have been consulted on this decision before it was imposed."

Group members believed:

Health care quality and access would be reduced for patients, with new targets for how many should be referred

A patient's right to a second opinion, and a doctor's obligation to give it, was being contravened

The restrictions would lead to a postcode lottery

There was no evidence that York's doctor referral rates - which are well above the national average - was good or bad clinical practice

There was no plan in place for where and how patients would be treated who would not now be referred to hospital.

"We recognise the difficult financial situation for the Selby and York PCT, but do not feel patient care should suffer simply to achieve financial balance in one year as ordered by the Government," said Dr Hartley, speaking on behalf of the group.

GPs wanted to keep their clinical freedom to refer patients when appropriate, and to see a full public debate on what the NHS could and could not pay for.

The four PCTs in York and North Yorkshire are facing a shortfall of £51 million for this financial year.

Janet Probert, director of nursing for Craven, Harrogate and Rural District Primary Care Trust said it was not intended to alienate GPs, but to create a consistent approach across North Yorkshire.

She said: "We do have to

commission sensibly and effectively across the whole of North Yorkshire at the moment. What we are very keen to do now is get GPs to respond to this."

Updated: 12:39 Saturday, May 20, 2006