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Fears are being raised over a blurring of the lines between private and NHS care after news emerged of GPs targeting patients for private work.

A York-based practice has written to its patients offering them a range of minor treatments privately, claiming they are not funded by the local NHS.

Doctors' leaders said this could be the start of a worrying trend due to the squeeze on finances and NHS overhaul.

But the government denied the case was related to these factors.

It comes after the Haxby Practice in York, which serves 20,000 patients, wrote to some offering patients the option of having work done privately.

Savings

The letter, seen by the ����ý, said local health chiefs had stopped funding a range of services, but added they could still have them done privately at a number of clinics, including one owned by the practice.

These included removing skin tags from £56.30 to treating benign tumours for £243.20.

In total, more than eight procedures were listed, although local NHS managers disputed claims that two of them had been banned.

Nonetheless, the case has prompted concern in the medical profession.

Royal College of GPs chairman Dr Clare Gerada said: "We believe that the boundary between what a GP offers under their NHS provision, and what is offered for a private fee, is in danger of becoming increasingly blurred.

"The NHS works because patients trust their doctors. This is especially so with GPs, and is something we cannot allow to be diminished."

Dr Richard Vautrey, of the British Medical Association, added: "The dire finances of many trusts means that many more NHS treatments are likely to become unavailable in the future.

"The BMA is very concerned by the potential conflicts of interest that this example exposes. The last thing any GP wants is to see patient trust damaged.

"Unfortunately the direction of travel in NHS policy, particularly combined with the financial situation, does increase the risk of conflicts of interest for GPs which is one the reasons the BMA is so concerned about the Health and Social Care Bill."

'Significant concerns'

The local NHS trust also expressed concern.

Dr David Geddes, medical director of NHS North Yorkshire and York, said: "We have significant concerns about this letter which we will be addressing with them directly and as a matter of urgency. We will then decide what further action is necessary.

"We were not made aware of this letter in advance. Had we been consulted we would have advised against its release."

He also pointed out that even in cases where treatments were not routinely provided, patients could still apply for NHS funding through the exceptional cases process.

A Department of Health spokeswoman said the policy changes being made did not make such cases more likely and instead took issue with the way patients had seemingly been approached.

"Advertising private healthcare options for the purpose of income generation is not an appropriate use of information provided by patients for the purposes of receiving NHS care. The code of conduct for the promotion of NHS-funded services makes this clear."

She added the Health Bill would actually end up strengthening the safeguards to prevent conflicts of interest as regulators will be charged with ensuring doctors stick to the rules.

But John McEvoy, managing partner at the Haxby Group, defended the move, pointing out that the letter had listed other private providers as well as the practice's own clinic.

"They had a choice to go elsewhere," he added.