POOR health services in East Lancashire could be a major reason for the rising cost of sending patients out of town for specialist treatment.

The claim was made as health bosses drew up plans to cut the increasing number of people referred to consultants outside the district.

East Lancashire Health Authority has predicted a major cash crisis if the problem of ECRs (Extra Contractual Referrals) is not tackled.

Spending is forecast to exceed £3 million in 1996/97 despite a £2.2 million budget.

One drastic option to make up the shortfall could be to redirect cash from cancer and mental health services.

Consultants can refer patients to hospitals outside the district if they believe they would receive better treatment.

GPs' spokesman on East Lancashire Health Authority, Dr Chris Ward, said the increase in some ECRs was a reflection on services locally. He said: "This is not something which has happened in a haphazard fashion, but a reflection of something not being right locally."

If the pressure grows, health chiefs are also considering asking GP fund-holders to help them pick up the extra cost of out-of-town treatment.

If treatment costs more then £6,000 the health authority picks up the tab for the extra cash. Delicate negotiations could start soon with the GP fund-holders to ask them to share the extra cash burden.

But Dr Ward said GPs did not wish to be the "gatekeepers" and felt strongly that it should be the responsibility of the health authority.

Bev Humphrey, director of strategic planning and contracting, said: "We are heading for significant problems so much that we may have to say no to clinical priority. That is what we are trying to avoid."

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