A SURGEON at the Royal Bolton Hospital has slammed the government in an outburst over so-called "patient choice".
Consultant orthopaedic surgeon Steve Hodgson says patients are being let down because in reality they get little choice of where they are treated.
And those who switch hospitals can be operated on by someone they do not know.
Mr Hodgson says he feels he is letting his patients down because he is not even told when patients are taken from his list.
The government introduced patient choice earlier this year to give all those on a waiting list for longer than six months the opportunity to have surgery in another nearby hospital.
Mr Hodgson says this can mean patients being treated miles away by a surgeon they have not met previously. It can also mean fewer visits from relatives and friends who cannot get to the alternative hospital.
Orthopaedic patients in Greater Manchester have been part of choice programme for 12 months in a government pilot scheme.
Mr Hodgson said: "Ever since this came in, they have been prepared to throw money at it -- but they are not prepared to give us the money in the first place."
He said that for the last three years the orthopaedic department in Bolton had been underfunded.
The Royal Bolton wanted to link up properly with the Wrightington Hospital, a specialist orthopaedic hospital, but the funding was not being made available.
"They would rather those patients go to other hospitals in Greater Manchester," he said.
"I don't think it's good for patients when they build up a trust with their surgeon only to go elsewhere."
Mr Hodgson said NHS hospitals were also sending patients on waiting lists to private hospitals, and he said the money it costs for the National Health Service to do that should be pumped into orthopaedic departments so they could operate on all their own patients quicker.
He added: "If we were given half the money we are paid to operate in private practice on patients who come to us under the NHS choice scheme, it would all run much more efficiently."
Mr Hodgson has 160 patients on his waiting list in Bolton for upper limb operations, but he does not know which of those patients he will be operating on.
The surgeon, who has been at the Royal Bolton Hospital for 12 years, said he was often not told when his patients had been moved to other hospitals.
Mr Hodgson said: "I often only find out from other surgeons who I know in the Manchester area who ring me about the patients.
"As far as I'm aware, from patients I have spoken to, patients are telephoned and told that a date has been arranged at a hospital and would they agree to go. I'm not sure how much choice patients actually get.
"The patients get a choice of Yes or No, not a list of hospitals where they can go to."
Mr Hodgson says personal assurances he has given to patients are removed by patient choice.
"Choice sounds very good, but it is just like any other political thing: in practice, it is not working as it should," he said.
"I feel like I'm letting my patients down because they think I'll be doing their operation. These decisions are made without discussion with the treating surgeon."
A Department of Health spokesman said: "We're committed to offering real choice for patients. Choice is being phased in, which is why some areas may have different experiences to others, but from the end of 2005 patients will have the right to choose from at least four to five different health providers.
"People want choice. Data from choice pilot areas -- which includes Greater Manchester -- shows that 32,195 patients were offered choice and 22,303 took up the offer -- nearly 70 per cent."
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