Health authority admits operating two-tier hospital admission system

A KENT health authority admitted yesterday that it had operated a two-tier system and imposed a 'temporary' delay in offering hospital treatment to non- urgent patients whose GPs are non-fundholders, writes Celia Hall.

The statement was made after an emergency meeting following claims that a two-tier system was being operated by an orthopaedic surgeon from the Dartford and Gravesham NHS Trust. The meeting took place as doctors at the British Medical Association annual conference in Birmingham criticised multi-tiered systems as unfair.

In a joint statement from the trust and West Kent Health Authority it was made clear that patients of non-fundholders would again be given the same treatment.

The surgeon, Anthony Leyshon, had been told to stop taking all but emergency and urgent patients from doctors in his area who did not run their own budgets because of a financial miscalculation. Mr Leyshon said that the instruction had arisen because the health authority had to claw back pounds 700,000.

The money was needed for the fourth wave of GP fundholders who had been given permission to begin running their own financial arrangements, making the money unavailable to other patients in Kent. It appeared to be the first time that the authority had to act in this way because of the miscalculation.

John Chawner, chairman of the BMA consultants committee said he believed it was the first time this had happened. 'If any cuts had to be made it would be easy to say that it should have been the fundholders' patients who should have been affected - but that too would have been inequitable,' he said.

A joint statement from West Kent and the Dartford NHS Trust said: 'At no time has the trust given instructions to stop emergency clinically urgent or pre-booked admissions.

'However, a decision was made temporarily not to call in any further non-urgent patients for treatment while GP fundholder adjustments to the contract were being finalised. The agreement provides for similar levels of activity for non-fundholding patients as in previous years.'