THE war of words that has broken out over hospital services in County Durham highlights the difficulties faced by health planners over the years.

By the 1990s it became increasingly clear that something had to be done about replacing run-down hospitals at Dryburn, in Durham, and Bishop Auckland.

Plans to build new hospitals at both sites go back to the 1960s, but the sites were repeatedly passed over when it came to publicly funded building schemes.

Dryburn was built in the 1940s as an emergency war-time medical unit.

While it gradually expanded to meet modern needs, it was clear that a replacement had to be found.

Parts of the original Bishop Auckland Hospital go back to Victorian times, and despite attempts at updating the facilities, medical staff longed for a modern hospital.

During the mid-1990s the then Conservative government developed the private finance initiative, known as PFI, which involved private developers building NHS hospitals and then effectively leasing them back to local NHS trusts.

This approach was adopted by Labour after the 1997 General Election.

Subsequently, new PFI hospitals have taken shape in North Durham and Bishop Auckland.

The £97m replacement for Dryburn - now known as the University Hospital of North Durham - opened in April.

Construction at the £67m Bishop Auckland General Hospital is well advanced and the unit is due to open next summer.

While managers, staff and patients agree that the new hospital is an enormous improvement on Dryburn, concerns have been expressed about the long-term financial burden imposed by PFI schemes.

In 1998, the chief executive of County Durham Health Authority, Ken Jarrold, wrote to the regional office of the NHS asking for an increased allocation of funds to offset the costs of the two PFI schemes.

This week, Kevin Earley, the out-going chairman of North Durham Health Care NHS Trust, voiced his concerns that Bishop Auckland hospital was not viable as a district general hospital and the PFI scheme was over- ambitious.

He believes that service charges will cripple other health services across County Durham.

Bosses at South Durham Health Care NHS Trust acknowledge that "difficult decisions" may have to be made about the future shape of NHS services, but defended the provision of modern facilities in Bishop Auckland