DOCTORS and hospital bosses have been condemned for blocking proposals to tackle a potential £156m NHS black hole.

Anger erupted at a meeting of North Yorkshire and York PCT yesterday after it emerged that GP-led clinical commissioning groups (CCGs) and hospital trusts had been unable to agree an action plan to reduce NHS spending in the county.

As recent appeals by MPs to Health Secretary Jeremy Hunt to increase NHS funding for the county were rejected, health services in the county must implement at least £55m in savings in the coming year.

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The trust’s chief executive, Chris Long, said: “This was the first attempt to agree some common themes. Trying to get any consensus on anything was a real challenge.”

It had been expected the long-awaited Clinical Services Review, which the county’s NHS paid auditors KPMG £320,000 to help produce, would detail a “hurricane of cuts” to services in a drive to stop the county’s £19m NHS debt from spiralling.

Instead, the report was limited to suggesting reviews of key services to the 800,000 residents, such as accident and emergency provision, community hospitals and out of hours services.

However, the report’s authors predicted by 2016, the county’s NHS may be facing a potential overall deficit of £156m, equivalent to 20 per cent of the county’s total health budget, unless urgent and comprehensive action was taken to cut costs.

It added: “These figures do not include the current structural deficit figure (£19m), so if this is not paid off by 2014, then the total figure could be significantly higher.”

Kevin McAleese, the trust’s chairman, said he felt embarrassed the report his trust commissioned had been kept secret until the meeting as it lacked any proposals to tackle the mounting financial crisis.

He said: “There’s no information how we will return to financial balance.”

North Yorkshire county councillor and health scrutiny committee member Coun John Blackie was so incensed he tore the document up.

Mr McAleese said due to the absence of proposals, his board could not approve the report and warned the CCGs faced a “severe strategic challenge” to implement the necessary savings before April 2014.

Board members described the report as a huge anti-climax, a missed opportunity and hugely disappointing.

They said the Government had “listened to, but not heard” their case for greater funding, which centres on the county receiving £213 less per patient annually than the regional average, despite it being the most rural PCT area with a high proportion of elderly residents.

Health watchdogs said they would continue pressing the Government for more funds, but feared the delay in making proposals could lead to yet higher debts.

Jim Clark, chairman of the county’s Scrutiny of Health Committee, said: “The longer they leave making decisions, the worse it is going to get.

“It’s a farce that they couldn’t even approve a report that they commissioned.

“The only way we can address the problems of providing healthcare in a large rural county is if we work together.”

Due to the absence of cost-cutting proposals, the required savings will be proportionately passed to CCGs.

Decisions on the future shape of NHS services in the county will be delayed until next year, as public consultation exercises on any major changes to services will not be launched until October.

Meanwhile, the debts will leave CCGs with an "enormous challenge", at a time the Hambleton, Richmondshire and Whitby CCG has been left struggling to financially plan as the Health Secretary considers a controversial blueprint to downgrade paediatric and maternity services at the Friarage Hospital, Northallerton.

CCG leaders defended the decision to delay making proposals, saying they felt uncomfortable making decisions about services in other areas of North Yorkshire and would be more able, as clinicians, to implement the savings.

While some CCGs said it would take some “minor miracles” to overcome the £19m debt while restructuring services, others said GPs would know where waste could be eradicated.

Amanda Bloor, of Harrogate and Rural District CCG said: “The CCGs wanted a chance to discuss items on their patch with stakeholders before coming up with any firm proposals.”

She said her CCG was confident it could balance its books by moves including reducing the number of emergency hospital admissions from nursing homes and cutting the number of patients needing transport to hospital.