'Unpalatable' cuts for North Yorkshire and York NHS
The NHS in North Yorkshire has warned it is so cash-strapped that it may not be able to pay for basic services.
In a paper to be discussed on Tuesday, officials will be told that "unpalatable actions" are needed.
NHS North Yorkshire and York Primary Care Trust forecast a £19m deficit for the current financial year, but by July was already facing a £16.1m overspend.
Previously, Dr John Crompton, who represents GPs in the area, had blamed years of under-funding.
In the report, the PCT board chairman Christopher Long tells members: "Immediate and extraordinary measures [are needed] to ensure we do not exceed that (£19m) figure".
And he goes on to say that some of the measures "whilst unpalatable, are vital".
He continues: "If the risk of overspend is not managed there is a significant threat that the organisation will not be able to make payments to trusts, GPs and other contractors for services and products such as drugs."
Mr Long said proposed actions included a "reduction to elective activity and ensuring that thresholds regarding treatment are adhered to".
Delays to a number of development schemes, including the expansion of health visiting services have been agreed, Mr Long asserts in the paper.
The full measures will be discussed at the meeting, but the Primary Care Trust document said that the short-term measures would run until at least 31 March 2013 when the PCT would be abolished.
Beyond that point, the responsibility for running the services falls to the four North Yorkshire Clinical Commissioning Groups.
In the document, Mr Long acknowledges the plans will not be popular, saying "it is fully acknowledged that the local population and our stakeholders will be uncomfortable with the short-term actions we need to take to ensure the deficit does not exceed £19m".
In June, Mr Long said the authority had got previous financial help from the NHS North of England Strategic Health Authority (SHA), but he said that body would cease to exist on 31 March 2013.
And he added: "It is clear that in the past it has been more expedient to support a recurring deficit than to address the underlying causes - essentially there is more health service available in North Yorkshire than can be afforded."
Dr Crompton said: "We have made efficiencies in North Yorkshire and I do have concerns about how far we can keep going without just reducing and reducing the amount of services we can have.
"We have a 100 practices in North Yorkshire and if we simply take away a chunk of funding that supports them providing services with their doctors and nurses, there is a real risk some of them will not survive.
"That is a real concern for the residents in North Yorkshire."