WE drew attention yesterday to the growing crisis in health care, and the iniquity of a system which denies treatment to local people simply because North Yorkshire health bosses have run into debt.

We make no apologies for returning to the subject today.

The body which represents GPs in the county has launched an extraordinary salvo against local health bureaucrats' cost-cutting plans.

The measures the primary care trust (PCT) has introduced to tackle its multi-million pound debt include everything from suspending back pain injections and removal of skin lesions, to requiring GPs to get approval from a panel before they can refer patients to hospital for key treatments.

Today, the North Yorkshire Local Medical Committee, which represents doctors, accused the PCT of a "total failure" to understand the needs of patients or the concept of clinical responsibility. In a stinging letter, medical committee secretary, Dr John Givans, said the PCT was making changes "on the hoof", and was "no longer able to meet its statutory obligations".

Any medical practitioner who agreed to sit on the panel that would vet GP referrals may be at risk of being sued, Dr Givans said. He warned doctors could not give patients the high quality care they deserved if required to "conform with the bureaucratic nonsense required by the PCT".

And he said they would defy attempts to block treatment by referring the same patient again and again, if necessary.

The rebuke is a damning indictment of primary care trust bosses' attempts to save money by cutting corners, and a revealing insight into the growing rift between medics and health bureaucrats locally. The NHS cannot continue to tear itself apart in this way. Because while it does, patients will suffer.