The NHS in England could be heading for a �620m deficit

Some London and Staffordshire hospitals have delayed non-emergency surgery as managers try to fend off deficits.

But the British Medical Association said it was up to managers, not doctors to sort out the finances.

Chairman James Johnson said it would be a denial of professional responsibility if doctors went against what was clinically right.

SAVING MONEY? Harrow - The PCT, which is facing a �3.4m deficit, has ordered local hospitals to delay operations as late as government targets allow Staffordshire - The University Hospital of North Staffordshire said it has been asked to reschedule non-emergency operations for around 500 patients by PCTs Oxford - The city's John Radcliffe Hospital has been told by managers to restrict the availability of cardiac ablation - the treatment Tony Blair was given

"We are seeing significant deficits at the moment and some trusts have responded by delaying operations.

"But doctors are not going to be part of playing silly games. We are not going to sit around twiddling our thumbs if operations could be done.

"It is up to trusts to sort out their own finances."

It is not known just how many trusts have decided to delay operations - Harrow Primary Care Trust in London were the first to be exposed before Christmas - so that they do not have to pay for them until the next financial year.

And Oxford's John Radcliffe Hospital has been told by managers to stop offering cardiac ablation - the heart treatment Tony Blair has been given - to all but the most urgent cases.

Deadline

But one in four trusts failed to balance their books last year, leaving the health service with a deficit of over �200m.

Health Secretary Patricia Hewitt has already admitted the situation could get worse this year with the NHS facing a �620m debt.

As well as delaying surgery up until the government six-month waiting deadline, trusts have also introduced recruitment freezes and closed wards.

James Johnson said better regulation was needed

Mr Johnson said recruitment freezes imposed in a flexible, sensible way would be preferable to operation delays.

But the leader of Britain's doctors also offered an olive branch to the government over reforms which are making the NHS more market driven.

He said doctors did not expect things to go back to the way they used to be and were willing to change with the times.

He even acknowledged doctors may become more like freelancers doing work for the private sector.

But he said it was important the increasing involvement of the private firms - one in 10 NHS operations are expected to be done by the independent sector by 2008 - needed to be accompanied by better regulation.

He said rules had to be in place to ensure a seamless transition when patients are transferred between services, protect vital services when a hospital fails, provide training for students, keep a check on standards and guard against the private sector being given advantages with guaranteed contracts.

Mr Johnson made his comments after a speech by Ms Hewitt on Tuesday in which she said there would be no let up in the pace of reforms such as patient choice and private involvement despite the deficits.

She said: "The NHS has improved dramatically since the 80s and early 90s.

"But now is the time to increase the pace of reform and to widen the scope of our ambition because we are within sight of an NHS where patients' demands and aspirations will be the key driver towards better, faster care and greater efficiency and value for money."

A Department of Health spokeswoman said there was "no question of doctors being asked to play games to improve finances" and tackling deficits did not mean compromising patient care.