THE changes being expanded across the NHS could lead to patients being charged for care, say experts.

Prof Cam Donaldson and Dr Danny Ruta, of the Newcastle University, said Government policies - such as giving patients greater choice over where they were treated - did not take into account limited resources and cash.

They said NHS trusts could be pushed further into deficit if they were left to pick up the bills for patients who make decisions without having to bear the financial responsibility.

The warning follows an admission by Health Secretary Patricia Hewitt that the NHS could be facing a deficit of £620m.

She published the figures shortly after officials revealed that the new contracts for consultants and GPs had gone almost £400m over budget.

Also, pay arrangements for other NHS staff are costing more than planned.

In the British Medical Journal, Prof Donaldson and Dr Ruta say a major failure in the policies has been "lack of recognition of cash limits and scarcity of resources".