Doctors reveal winter chaos in NHS

The National Health Service is in the midst of a winter crisis of delays to operations and ward and hospital closures, according to a leaked paper drawn up for doctors' leaders yesterday.

Labour called for an emergency Commons statement from the Secretary of State for Health, Stephen Dorrell, as Britain experienced snow and freezing conditions, with accident and emergency centres across the country reporting rapid increases in demand, leaving many stretched to the limit and some unable to cope.

Hospitals are telling GPs not to refer any more patients until April, when the next financial year begins.

In response, some GPs are advising patients to refer themselves to accident departments. The flu epidemic has added to the strain on the NHS, with more patients, and staff going sick.

The issue is certain to become part of the general election battle. Labour has guaranteed to match the pounds 1.2bn increase for the NHS next year but has refused to make pledges about more for future years.

BMA sources said they believed the present difficulties were probably the worst in the NHS in a decade.

The core problem, doctors believe, is a lack of resources, despite an extra pounds 25m announced by Mr Dorrell on Christmas Eve.

Chris Smith, shadow health secretary, said of the report: "It shows that, whatever the claims made by the Government, the reality is a health service under massive pressure, beset by funding difficulties and slipping into crisis."

The BMA is seeking an urgent meeting with Mr Dorrell on the findings of its national survey. The report showed:

Nottingham - Queens Medical Centre: Doctors instructed to admit only urgent surgical cases and those who have been waiting for 18 months for treatment, the limit under the Government's Patient's Charter.

Wales: Four large hospitals closed to non-emergency cases because of the weather and flu.

South London: 24 patients waiting on trolleys in Accident and Emergency in the early morning, with no prospect of being admitted until the afternoon at the earliest.

East London: No elective surgery or routine work until after April 1997 outside the three Tower Hamlets hospitals (Homerton, Royal, and Newham) to improve financial viability of these three trusts by referring all cases to them.

Leeds: no more elective gynaecology work for next few months. Bed crises mean that beds in specialist units have to borrowed for emergencies.

North Staffordshire Trust: A&E department - admissions and sickness forced a consultant to work without a break for 36 hours from Monday morning to 2pm on Tuesday.

The cuts in elective treatments are also having a "major impact" on medical students. The chairman of the medical students committee started a three- week placement at Bart's/Royal London to find paediatric A&E and other wards closed.

A BMA spokesman said: "Last October we warned that the light was at amber and if it got worse, it would be at red. The red lights are now on.

"People are waiting in ambulances because there are no beds. In Nottingham, the shortages are in crisis proportions. Letters have gone out virtually stopping everything.

"We are getting reports of crisis in other parts of the country almost daily."

Gerry Malone, the Health Minister, said: "We anticipated the harsh winter and that is why we implemented a plan of action and provided additional money for extra services.

"It is nonsensical for the Labour Party to complain about funding when they won't match the Prime Minister's pledge of year on year increased spending on the NHS."