Plans to have the NHS and the private sector compete for GP referrals in north Cumbria should be shelved in favour of the two working together, its primary care trust has said.

Cumbria PCT said NHS consultants should work for Netcare following union fears that competition would damage existing NHS hospitals.

The competition proposals formed part of NHS North West's clinical assessment, treatment and support service scheme for Cumbria and Lancashire. Director of market development at the PCT Nigel Maguire said: 'We are proposing a partnership that would remove the element of contestability.'

The original plans, unveiled by the strategic health authority last year, were fiercely opposed by the British Medical Assocation, unions and the local press.

The BMA argued privately run centres would destabilise local hospitals by taking core business away and undermining GPs' autonomy.

But NHS North West argued that the independent schemes were needed to meet the 18-week referral-to-treatment target.

BMA consultants committee chair Dr Jonathan Fielden said: 'We do not oppose the schemes in principle but do oppose them when they put the NHS in competition with the NHS.'

The proposed scheme in Cumbria, due to start in January 2008, would see all GP orthopaedic and rheumatology referrals go to the clinical assessment, treatment and support service at Carlisle Infirmary and Workington Community Hospital. Patients would be assessed by an NHS consultant and offered any diagnostics needed. They would then choose where to go for hospital treatment but could opt to stay within the service or at the hospital's NHS services.

Mr Maguire said: 'The advantage for patients is that they will be able to see the same consultant right through their treatment episode.' The arrangement would allow staff to learn new ways of working while safeguarding their jobs, he added.

In South Cumbria and Lancashire, the Netcare-run clinical assessment, treatment and support service would still be in competition with the local NHS.

Mr Maguire was not aware of any other service being set up along these lines. The contract was now in negotiation and he hoped it would be signed in the autumn.

Netcare director of corporate affairs Julia Eadie said: 'We want the business and nothing is off the table.'