PLANNED changes to the way health visitors and school nurses work in York have major flaws, child health experts have warned.

At a discussion on the issue at a council meeting, worried doctors fiercely opposed plans for an overhauled "Healthy Child Programme", with City of York Council taking over the service from the NHS.

The council has been responsible for the 5-19 year old child health programmes since April 2013, and will take over the 0-5 years service from October, but until now the council has contracted the work out to NHS teams.

But the council's new plan would see the NHS contracts and the nurses and health visitors instead move "in house".

Dr Robert Smith, York Hospital's clinical director children's services and a consultant paediatrician of 22 years experience, told the council's executive of serious concerns from his fellow paediatricians.

He said: "York had a well-integrated, seamless child health programme. It is now being fragmented by the commissioning process. We cannot see any advantage to healthy children in York by this."

The new in-house plan will help the council "realign the budget" to other council priorities, rather than being tied to the NHS's previous investment decisions, a written report to the executive said.

But the plan will see the nurses work without clinical supervision from trained paediatricians, Dr Smith warned, and without the training, or help and support from the myriad departments they can currently call on in York NHS.

The proposals lack understanding of clinical paediatrics, he said, and would leave the nurses and health visitors being supervised by the council's director of public health, who is not a trained paediatrician, he added.

A lengthy list of concerns Dr Smith outlined included a lack of consultation with people who currently work on the service on what exactly the new provision will look like.

He also said doctors were worried there was no plan for children to be referred for further treatment if problems were spotted through screening programmes or even what conditions would be checked for; and said there were concerns there were no arrangements for performance monitoring.

Sharon Stoltz, the council's interim director of public health, and Jon Stonehouse, its director of children's services, told councillors it was an opportunity to create a properly integrated child health and education service.

Ms Stoltz said: "This is an opportunity to think about the future of the service and how we can deliver a more family focused and community based model of service."

She said she understood concerns about professional and clinical supervision, adding that a full human resources plan would be developed.

Cllr Carol Runciman, the executive member for health, also spoke in support of the new plan, adding that while it was regrettable the paediatricians had not been informed of the proposal sooner, the "in house" service was the way forward as the council looked to integrate services and put them in the community.

The Labour group representative at executive, Cllr Stuart Barnes, said they were not opposed to te "direction of travel" but were concerned over an "extremely ambitious" six-month implementation plan.