Dr Sandy Macara, chairman of council of the BMA, added his warning to that of Professor Leslie Turnberg, chairman of the Conference of Medical Royal Colleges, that patients with potentially life-threatening conditions were having to wait for treatment in the new-style NHS. Urgent cases, he said, were being squeezed between growing emergency admissions and government guarantees that patients would not have to wait too long.
If ministers wanted to keep their two-year guarantee, more money would have to be found if patients needing urgent treatment were not to be made to wait, he said.
'More funds will have to go into the system to avoid us having to make choices that cause real sacrifices for patients, such as are happening at the moment,' he said. The alternative was for the Government to drop its two-year guarantee.
While there had been real increases in NHS spending in recent years, much of it had gone into running the NHS internal market, with a huge rise in managers needed to run the new contracting system, he said. 'This money has not been available for direct patient care.'
Dr Macara said there had been 'a quite remarkable increase in the number of emergency admissions' to hospitals. It might be that GPs were referring their patients as emergencies to ensure they received treatment after hospitals had had to halt non-emergency patients unless they came from GP fundholders.
He said the early signs were that hospitals were completing their contracts for district health authorities even earlier this year so that patients who did not come from GP fundholders would have to wait months for treatment until the new financial year in April.
The BMA is arguing that the NHS needs an extra pounds 4.5bn on top of the current pounds 36bn budget to bring spending up to the average for other industrialised countries.
Meanwhile David Blunkett, Labour's health spokesman, attacked proposals being considered by Virginia Bottomley, the Secretary of State for Health, for guidelines to be drawn up on what constitutes an 'urgent' case. Such cases would be guaranteed treatment within six weeks.
Mr Blunkett said: 'The NHS doesn't need more complicated procedures to restate what should be a basic rule - if you need urgent treatment, you should get it.' Mrs Bottomley was threatening to build 'layer upon layer' of bureaucracy over waiting lists, he said.
Family doctors can immediately remove from their lists patients who assault them or their staff, Mrs Bottomley said yesterday.