Channel 4 News learns that a flagship PFI hospital in Wakefield is turning away patients arriving in ambulances because of a lack of capacity. North of England Correspondent Morland Sanders reports.
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Call 999 within the Mid Yorkshire NHS Trust and where you end up may be something of a lottery.
Your nearest A&E could be in Pontefract but at night you can expect it to be shut - reportedly down to staff shortages.
The next nearest option within the Trust is the brand new Pinderfields Hospital, this is an impressive facility, huge car parks, cheery blocks of colour break up the exterior and a helipad awaits to ferry in the critically ill.
But Channel 4 News has learned that this hospital too has been turning away patients in the back of ambulances.
In total mid-Yorkshire declared 87 what it calls 'Service Transfers' last year. Each lasts between two and 10 hours and are the result of the hospital having no further capacity. Patients will normally be taken to Dewsbury a further 10 miles away.
These diversions have not gone down well with The College of Paramedics. Jim Petter, director of professional standards, told Channel 4 News: "Patients may be suffering if it takes longer to get them to a point of definitive care".
Shadow Home Secretary Yvette Cooper, also a local MP, described the figures as dreadful: "What that means is huge number of patients supposed to be going to Pinderfields being sent and not given the treatment they need as fast as they need it."
What that means is huge number of patients supposed to be going to Pinderfields being sent and not given the treatment they need as fast as they need it. Yvette Cooper
We were told nobody at the Trust was available for interview but they did provide us with a statement, claiming the diversions were occasional:
"In common with other multi-hospital trusts we use our available capacity on all sites to manage emergency demand in the safest and most effective way for the benefit of our patients. With the support of the ambulance service, we occasionally divert ambulances to the site with available capacity to allow patients to be admitted for care in the most timely way.
"Critically ill or injured patients always go to the nearest appropriate emergency department. The temporary overnight closure of Pontefract Hospital emergency department has not led to an increase in the number of ambulance diverts at our Trust".
Unions see the diversions as a symptom of a blinding mismatch of patient provision and demand. They say the new Pinderfields hospital has fewer beds than the one it replaced.
Private Finance Initiative (PFI)
It was built under a Private Finance Initiative (PFI) agreement, costing an estimated £330m, which Adrian O'Malley from the mid-Yorkshire Unison branch argues is leaving the trust with crippling debt.
"We wrote to MPs, various ministers both Labour and conservative and there's nobody who can say they weren't aware of this," he said, "and on the cost of the hospital, we're having to pay £40m to the PFI company putting even more pressure on patients and staff in the hospital."
So who came up with that PFI agreement? That was the previous government and yet Yvette Cooper MP doesn't see the problems in mid-Yorkshire as Labour's making.
Whatever the causes, the long term prognosis for Pinderfields may not be good. The PFI arrangement is in place for 35 years and the hospital was built smaller with the hope that more people could be treated in the community - according to the paramedics we've spoken to that just isn't happening.