THE body representing NHS patients in Craven and Harrogate has criticised reforms which are failing to deliver services.

It has warned that local doctors are particularly concerned at arrangements which could contradict their own code of ethics.

And it says the failure to deliver promises about upgrading Skipton General Hospital can only harm the trust people have in the NHS.

The report has been prepared by the Craven, Harrogate and Rural District Locality Working Group of the North Yorkshire Public and Patients Involvement in Health Forum.

The forum has to prepare an annual health check and its members in the Craven and Harrogate area have taken the opportunity to deliver an unfavourable verdict on the new North Yorkshire and York Primary Care Trust, which was formed by the merger of four smaller trusts in the county.

The Craven and Harrogate group says that doctors are concerned about a cost-cutting system introduced by the PCT.

Patients referred by a GP for some hospital treatments, for example hip replacements, have to be first "approved" by a medical panel before treatment can go ahead.

"Doctors have expressed concern that the system imposed is a contradiction of their own code of ethics," says the report.

The report also picks up on the widespread resentment in Craven about promises for the redevelopment of Skipton General Hospital, which have been broken.

"We have been given to understand that agreement had been reached on forward plans with the Strategic Health Authority, but the PCT board appears to have shelved' any proposal and seems unable to give clear assurances with regard to this site to help build public confidence," says the report.

"There also appears to be lack of clear purpose at Castleberg Community Hospital near Settle, where the previous accepted practice of respite care is now denied as ever having been included in service provision."

The group says that when the former Craven Harrogate and Rural District Primary Care Trust was abolished to make way for the new body, patients in Craven and Harrogate were promised publicly that the area would not be disadvantaged by the "profligacy" of other PCTs.

"It now seems that these promises are to be ignored," said the report. "The Craven and Harrogate group is most concerned about the effect that actions like this have on integrity in public life and the trust of local people in what board representatives of NHS organisations say."

Later, it says that Selby, the PCT which entered the new body with the largest deficit, has been "rewarded" with a modest capital scheme, while Craven and Harrogate, which had a negligible deficit, has had its Skipton hospital project shelved.

It concludes: "The Craven and Harrogate group believes that in the Craven and Harrogate locality people consider that the move in merging four PCTs has been retrograde, not to the benefit of local patients.

"The area of the new PCT is probably the largest in the country and it seems that geography alone can prevent a central PCT board being able to manage locally and in a fair way throughout the county. Particularly there will not be health benefits for people living in rural communities."

While the criticism may well embarrass the PCT in the short term, they can at least look forward to the end of the year - when Public and Patient Involvement Forums are being abolished.