MARY NEWSTEAD (above) never had much need of hospitals. A brief stay for the birth of her seventh child was her only experience in 70 years. But she always assumed that if she needed treatment, it would be available. She did not reckon on the anomalies of the NHS internal market.

Mrs Newstead, a widow from Salisbury, has suffered from carpal tunnel syndrome, a painful condition of the wrist and fingers, for almost two years. Steroids helped for a time, but increasingly she has found it difficult to knit, sew, or garden.

In May her GP, Dr Dougal Jeffries, a partner in a non-fundholding practice, decided surgery was necessary and referred her to the Salisbury Healthcare NHS Trust. She was seen by a consultant on 27 September who agreed that an operation was advisable. Mrs Newstead, whose husband had died just three weeks earlier after minor surgery, said she didn't want a general anaesthetic. Her surgeon agreed to a local anaesthetic and sent her to the Day Surgery Centre.

"They took all my details and said 'yes, we can do it in a fortnight,' and said they'd write to me," Mrs Newstead said. Five minutes after she arrived home the hospital rang to tell her the operation would have to be postponed until next April.

"The lady said the only way I could get it sooner was to pay myself or change to a fund-holding GP," Mrs Newstead said. "Dr Jeffries said it might be pounds 500. If it was pounds 200 or pounds 300 I could manage that but it is a bit too expensive.

"It isn't fair is it? My husband paid in [to the NHS] for years and we never really used it. I don't want to go to another GP. Dr Jeffries has been my doctor for five years and I can walk to his surgery. I was really pleased when they told me the operation could be done so quickly. Now I suppose I'll have to wait."

A spokesman for the Salisbury Healthcare NHS Trust said an investigation was under way to establish exactly what Mrs Newstead had been told about when she could have the operation.

Photograph by DAVID ROSE