HEALTH officials last night defended a decision to send a North-East delegation on an £84,000 mission to Japan - to find new ways of "increasing efficiency".

Families of patients denied drugs on the NHS, as well as two GPs, have criticised the trip to study Toyota's "lean management" techniques at a time when cash-strapped health authorities are trying to cut costs.

But the North-East Strategic Health Authority stood by the decision last night, insisting that the lessons learnt would save money and make the NHS more efficient.

Last month's visit cost £84,000 to fly a 14-strong team to Japan. Officials said the cash came from "central training funds".

The group - made up of senior doctors and chief executives - visited Toyota to see the management systems that have made it the world's biggest car maker.

Although similar "lean management" techniques were introduced at the Royal Bolton Hospital last year, and Toyota have a car factory in Derbyshire, the North-East NHS said it was the lack of other examples in the UK that led to the decision to go to Japan.

They hope to put the lessons learnt from Toyota into practice in the North-East, leading to reduced waste, greater efficiency, better patient safety and improved quality in the delivery of healthcare.

But family doctors said the timing could not have been worse, when the NHS is embroiled in a row over costly drug treatments not available on the health service.

The trip followed a decision to send a smaller North-East delegation to the US earlier this year, where they observed the same techniques being used in a hospital.

Darlington GP Dr Ahmed Fuat, whose mother-in-law, Pamela Smith, had to go private after being denied NHS access to an advanced new bowel cancer drug called Erbitux, said: "I think it is a disgrace. They are not giving people treatment and then sending people to Japan."

He added: "Why couldn't they have gone to Nissan at Sunderland and seen how they run their business?"

Dr Andrew Saunderson, who recently retired as a GP after working in Spennymoor, County Durham, for 34 years, said: "It strikes me there must be easier ways of getting this information - the internet for example.

"I have to be convinced that a trip to Japan will tell you how they do things. It may not be transferable to our culture, and the technique of making cars is an entirely different process from caring for people."

Madelaine Hodgson's husband, John, died four days ago from kidney cancer after he was denied vital drugs on the NHS.

She said the trip was sickening, and added: "I feel passionately that these drugs should be available to patients like John.

"If he had been given the drug six months ago, when he was stronger, it might have been a different story."

Ray Devonport, from Newton Aycliffe, County Durham, whose wife, Kathleen, 63, has been able to get access to an advanced kidney cancer drug - called Nexavar - only through the generosity of an anonymous benefactor, who paid her 9,000 drug bill, also took a dim view of the trip.

He said: "I think it is obscene turning their backs on cancer sufferers, yet spending money on jaunts. "They have sentenced my wife to a slow, awful death, and they are sending people to Japan."

A spokeswoman for County Durham Primary Care Trust confirmed that one member of staff - medical director Dr Hilton Dixon - was part of the delegation that visited Toyota.

The spokeswoman said: "No resources were diverted from patient care - specific national funding was made available to fund this training and development visit."

She said the decision to send a team to Japan was taken because there were no similar examples locally or nationally.