THE NHS will end up bearing costs of red tape caused by a congestion charge in Greater Manchester, MPs warned last night.

Hospitals and GPs' surgeries will be expected to fill in paperwork to allow patients to avoid paying when they travel to appointments.

And appointment booking systems will have to be 'modified' to help people avoid the peak-hour only charge, according to the head of the health service in Manchester.

One MP described the situation as 'absolutely intolerable'. And a spokesman for the British Medical Association warned the extra work in processing and assessing claims was 'bound to have a knock-on effect for front line services'.

But the 'yes' campaign in the congestion-charge referendum dismissed the claims as 'bizarre'. 

The 'yes' campaign said the extra administrative burden on the NHS would be minimal. "This is the most bizarre allegation yet from the 'no' campaign," said a spokesman. "They are fighting on fears rather than facts." 

And they pointed to evidence from a medical expert which suggested the introduction of a congestion charge would save 135 lives a year by cutting accidents.

Greater Manchester's councils are bidding for more than £2.75bn to be ploughed into transport schemes, including £318m to set up a peak hour, weekday congestion charge.

Some £1.2bn of the total would be in the form of a loan, paid back over 30 years out of profits from the charge.

Under plans confirmed last month, thousands of people a year attending 'regular' medical appointment will get a 100 per cent exemption.

Now it has emerged that hospitals and surgeries will be expected to administer the scheme themselves.

Patients who have incurred a charge will tell medical staff the number plate of the vehicle they arrived in.

NHS staff will then be responsible for assessing the patient's claim against charging guidelines, which are still being finalised.

All decisions will be vetted under an 'audit and enforcement process', according to official bid documents.

Laura Roberts, chief executive of NHS Manchester, confirmed in a letter to the leader of Stockport council that booking systems would be changed to allow people to try to avoid the charge.

She said efforts were being made to ensure the costs to the NHS of administering the charge would be 'minimal'.

Exempt

"It is intended that patients attending for treatment regularly (e.g. cancer patients receiving a ten-day course of radiotherapy) would be exempt and not have to complete multiple forms of paperwork," she wrote.

"Also booking systems will be modified to ensure patients are fully informed and can choose appointment slots that avoid the charge, and for those able to travel by public transport information will be given about improved public transport routes."

Kailash Chand, BMA spokesman for Greater Manchester, said: "I am very disappointed. "It is not like we do not have enough paperwork to do.

"This is bound to have a knock-on effect for front-line services and clinical care could suffer. It could also threaten the relationship with the patient if they are turned down [for an exemption]."

Graham Stringer, the Labour MP for Manchester Blackley, said: "This is absolutely intolerable. Hardworking NHS staff will be diverted from patient care to administering the congestion charge discount.

"There are around 30 hospitals in Greater Manchester. This means thousands of patients will be affected. It is ridiculous to suggest all appointments during congestion charging times can simply be moved.

Andrew Gwynne, MP for Denton and Reddish, said: "Under current proposals this scheme is unworkable, places an unacceptable drain on NHS finance, and an inappropriate strain on staff time filling in congestion charge paper work."

The news came as Dr Sally Bradley, director of public health for NHS Manchester, claimed the charge could save 135 lives a year by reducing road accidents.

In a new report, she wrote: "It is estimated that the TIF package changes could provide a reduction in peak hour traffic across Greater Manchester of between 8.5 per cent and 14 per cent.

"This makes it much more likely that the health benefits of the TIF package in terms of reductions in local air pollution will be delivered.

"There similarly is likely to be an improvement in the incidence of road traffic accidents as a consequence to the overall reduction of vehicle/km and a mode shift away from private to public transport.

Experience from the London congestion charge zone indicates there were 11 per cent fewer accidents in the second year after charging than during the previous 12 month period, compared with nine per cent across the rest of London.

"Health benefits of increased walking and cycling due to the package include primarily a reduction in the proportion of preventable deaths from coronary heart disease, stroke and colon cancer due to physical inactivity."

Click her to read the c-charge story so far.

Click here to read TIF documents released under the Freedom of Information Act.

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