DOCTORS today warned that patients could soon find no help in giving up cigarettes at their surgeries, thanks to a cash crisis.

Belt-tightening in the NHS means GP surgeries in York might have to stop offering services like quit smoking advice and blood tests, doctors fear.

Instead, nurses in surgeries may spend their time doing more profitable tasks like putting together insurance claims.

GP Dr Brian McGregor, secretary of the local medical sub-committee in York, said GPs in the city were facing a sharp drop in income this year because of a nationwide cutback in funding for local surgeries.

They also fear they may longer be given an extra budget for "enhanced services" - which includes blood tests, which would instead have to be given in hospital.

"What nurses spend a lot of time on but we get very little income for is smoking cessation," he said.

"That's quite an intensive scheme. You see people several times over a number of weeks - a lot of nurses' time is giving advice and consultation but the finance you get for it is a very, very small, it's literally peanuts. We all think it's a good thing so we all do it at the moment.

"As funding goes, you'll find services will go.

"We will use nurses for things that generate income like insurance reports. We'd rather work for the NHS than work for private healthcare. (But) it's a possibility that GPs will have to look at (other) ways to raise money.

"At the moment the NHS isn't increasing funding. You can't have a business that has expenses and costs going up and income going down.

"I don't think there's a single GP in this area who expects their income to go up or stay level."

The Government's contract for GP practices meant there was no increase in funding for living costs or inflation in 2006/7.

Dr McGregor said this meant GPs themselves faced an income drop because many of them still gave their staff a pay rise in line with inflation - and some above.

The Government also revised a scheme called Quality and Outcomes Framework (QOF) payments - a kind of bonus scheme for GP surgeries - by changing the targets they had to meet.

Josie Wheat, 59, from Tadcaster, gave up smoking 13 months ago after being given advice by her GP surgery who put her in touch with the PCT-run North Yorkshire Stop Smoking Service.

She thought it was "completely disgraceful" that smoking cessation in GPs' surgeries might have to be stopped because of funding cuts.

"It's so short-sighted," she said. "It saves money in the long run if you can get people to stop smoking. My GP practice said you have to try and give up smoking: we can refer you to a non-smoking clinic.' (Without them), I would never have found that service.

"I'm here a year on, healthier and fitter because that nurse said to me you've got to go to a no-smoking service.

"I can't believe that might be unavailable to people because of a shortage of funds. There has to be somewhere else they can find the money from."

NHS cash crisis claims 16 York beds

SIXTEEN NHS beds are to go in York because of huge health cuts.

Selby and York Primary Care Trust (PCT) needs to save £22.8 million this year to balance its books - and part of its plans include withdrawing money from York's care services.

That means an 11-bed unit at Grove House, off Monkgate, will shut, along with five beds at Archways - a 30-bed facility run by the PCT.

Coun Sue Galloway, the council's adult social services chief, explained the beds were used for "intermediate care".

That meant patients were sent there either to rehabilitate from hospital treatment or to avoid going there in the first place.

It also helped keep bed-blocking numbers down. Councils are fined if they fail to provide alternative accommodation for patients stuck unnecessarily in hospital.

Coun Galloway said: "These facilities have provided a valuable resource which has enabled us to keep delayed discharges from the local hospital at zero levels.

"Support has been provided to residents enabling them either to avoid hospital admission entirely or to go home earlier.

"In 2002 it was claimed that 50 additional intermediate care beds were required and £1.2 million was made available by the NHS to achieve this. At the time Hugh Bayley, MP for York, criticised the lack of provision yet here we are, two years down the line, with more elderly residents than ever before requiring our services, reducing capacity in order to balance the PCT's books.

"I warned some months ago that there would be a knock-on effect on local authority budgets and this is now proving to be the case. In addition, we are forecasting an increased demand for our services - especially homecare - aimed at looking after people in their own homes."

The PCT is withdrawing £50,000 of funding to cut beds at Grove House, and a further £25,000 of cuts are earmarked for a "review of intermediate care costs."

The 11 beds which are being closed at Grove House, an elderly people's home, are contained in a separate unit.

Coun Galloway said patients would not have to be moved because the service was being gradually run down - and it will finally close this winter.

"I do want to make it absolutely clear that we're not forcing people to be made redundant, we're looking to redeploy people in other areas," she said.

It is not yet known what use will be made of the empty unit. Red Roofs, which also provided intermediate care for people leaving mental health care, was also axed earlier this year as part of the PCT's cuts.

How 30-a-day man quit

NIGEL Knapton, 37, of Easingwold, stopped smoking two years ago with the help of the North Yorkshire Stop Smoking Service.

He said: "Any cutbacks in the stop smoking campaign is a backward step.

"The Government is constantly putting healthcare warnings on cigarettes saying you should all be giving up. They can't be doing that on the one hand and taking funding away with the other."

Nigel, a computer systems administrator, smoked 30 cigarettes a day between the ages of 18 and 35.

A spokeswoman for the Department of Health said: "People can get support to help them quit smoking in a number of ways - primary care trusts offer dedicated NHS stop smoking services and the department is funding a network of local alliances for action on smoking.

"These alliances form the bridge between the treatment services and the local authorities, community groups, businesses, schools, churches etc and will work with the most deprived sections of their communities to make a difference.

"We have allocated £112 million to PCTs over the two years and expect them to use this to help reach national stop-smoking targets.

"This builds on a previous investment of £138 million over the last three years."

The North Yorkshire Stop Smoking Service is available on 01904 663310.

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