The hospital lottery

The scandal of bed closures and cancelled operations in the NHS cash crisis took a dramatic new turn today. A London hospital is carrying out only half the 800 operations it is capable of because local Primary Care Trusts do not have money to pay for them.

It means London patients are being left to suffer while their places are being taken by people brought in from farther afield. The hospitals are even advertising as far away as Northern Ireland and Wales to fill their empty beds.

One victim of the cash squeeze is Acton care worker Lisa Grimshaw, who has been in constant pain for four months after damaging her knee in a fall at her home.

The nearby Ravenscourt Park Hospital says its orthopaedic specialists could operate on her "pretty much straight away".

But Mrs Grimshaw faces more months of agony because her local Primary Care Trust cannot afford to send her there.

The Evening Standard has already revealed that Ravenscourt's sister hospital, Hammersmith, has closed 100 beds and treatment for thousands of patients is being delayed for months.

Mrs Grimshaw, 35, has been struggling on crutches since the accident in June, in which she chipped the cartilage in her left knee.

"I got a call two weeks after my referral saying I couldn't have the operation because my PCT hasn't got the money," she said. "I am desperate to have the operation. All I want to do is get on that bed."

She is unable to work because she is not supposed to spend more than 10 minutes a day on her feet.

"I'm in a lot of pain," she said. "I'm frightened I could lose my job. I'm normally very active in my work, I walk between client's houses, I do their cleaning, laundry and shopping."

Mrs Grimshaw does not blame doctors at Ravenscourt Park for the delay: "They have said to me, 'We'd love to have you here, but the money isn't there to treat you'.

"They've been brilliant and this isn't their fault. I just hope the PCT can get this sorted out."

Orthopaedic procedures, such as hip and knee replacements, are deemed non-urgent and are being postponed until the next financial year, when more money will be available.

A spokesman for Ealing PCT, which covers Acton, said: "We are asking Ravenscourt Park to hold off on any more operations until February. We only have a finite pot of money. These are otherwise fit and healthy people and in the long term we are raising questions about whether these people need to have operations."

Hammersmith Hospitals NHS Trust, which runs Ravenscourt Park on behalf of the NHS, has been told it is racing ahead of Government targets and must slow down. Three PCTs - Hammersmith and Fulham, Ealing and Hounslow - are facing a financial crisis unless fewer of their patients are treated this year. This has created problems at Hammersmith Hospital, Charing Cross, Chelsea and Westminster and now Ravenscourt Park.

Ravenscourt has taken patients from Bath, Uxbridge, Surrey, Southend and Portsmouth in an attempt to stay busy.

Anaesthetist and clinical director Bruce Arrigoni said it was unlikely that any local patients would be treated at the hospital before Christmas.

"It is frustrating, we are a victim of our own success," he said. "It is demoralising for the surgeons to know there are local patients who need treating, we have the facility to treat them and the doctors to do it but the money is not there."

A Ravenscourt hospital spokesman said: "We offer a high-quality service with high patient satisfaction.

"We can treat patients pretty much straight away but the NHS cannot afford for them to be treated here. We treat about 400 patients a month but if the funding was available, we could treat 800.

"We market the facility to GPs in our sector and to other areas, such as Northern Ireland and Wales, where waiting lists are high."

Sally Hargreaves, chief executive of Hammersmith and Fulham PCT, said there was not enough money to keep pace with the rate at which patients were being treated.

The PCT is facing a £ 20million deficit and needs to save £5 million by treating fewer patients in this financial year. Ealing PCT and Hounslow PCT have lower deficits, but are still struggling.

Ms Hargreaves said: "Our patients can get treated, and they can get treated in line with the national targets of between six and nine months, but we haven't got enough money to treat them within two months.

"If we treated them within two months then other areas in the NHS would suffer, we would have less to invest in primary care. We want to achieve balance in the service."

Jonathan Gough, of the Ealing, Acton and Shepherd's Bush Conservative Association, said: "It's appalling that these patients have been relegated to the bottom of the queue simply because another borough's cash has run out."