A TOP surgeon at York Hospital has slammed proposals to "ration" the number of NHS operations, saying the plans are "a block to effective patient care".

Piet De Boer, senior consultant orthopaedic surgeon at the hospital, wrote to The Press after we revealed many treatments could be restricted to help overcome the NHS's cash crisis.

He praised the Press for exposing the effect of the changes, which came into force today.

Mr de Boer urged patients and their carers to "express their views" to bosses of primary care trusts in York and North Yorkshire, who are behind the new rules.

He said disguising the changes as anything other than a cost-cutting programme was "perverse".

Mr De Boer has been at York Hospital for 21 years, but is leaving to move to Switzerland in three months. He fired a parting shot at the money-saving measures being implemented.

On Friday, The Press revealed NHS bosses' plans, including:

Limiting the availability of sterilisations and vasectomies

lOsteoarthritis sufferers awaiting knee or hip replacements having to hit an increased "pain threshold" before getting an operation, and being offered other care, such as physiotherapy, in the meantime

lA new threshold for cataract operations.

Senior GPs and local medical groups have already attacked the plans.

Mr de Boer told The Press: "It's absolutely terrible. What happened in the past was, a patient would go to a GP, and the GP would make a decision on whether to refer people on. York GPs are a superb lot, and they sent on who needed to be sent.

"In 20 years, I do not think I can remember more than about five cases that did not need to see me."

He said the new scoring system, designed to quantify a patient's suffering, insulted GPs and gave them more work to do.

Mr De Boer, who has carried out more than 3,000 knee and hip replacements, added: "I think the current system is ripping off patients and belittling the GPs of York. In his letter, Mr De Boer wrote: "I know of no orthopaedic surgeon who regards these scoring systems as anything but a block to effective patient care."

Updated: 10:13 Monday, May 22, 2006