BBC NEWS Leading hospitals in England say they may be forced to refuse patients who want to top up their care because they fear they could be breaching NHS rules.
Elite hospitals with foundation trust status have a cap on the number of patients they can treat privately.
And NHS managers have warned that unless the limit is scrapped they will have to send top-up patients elsewhere.
The House of Lords is due to debate scrapping the cap, but unions have said such a move could harm NHS care.
It was only in November that the government agreed to allow top-ups - where patients pay privately for care not available on the health service while continuing to receive their basic package of NHS treatment.
But now foundation trusts have said the policy could unravel because of the long-standing rule on private patient income.
Sue Slipman, director of the Foundation Trust Network, said: "Hospitals are worried that because they are close to the cap they will have to send patients to other centres.
"Top-ups are still bedding in, but in the future it could be a serious problem."
However, Unison is opposed to scrapping the cap.
A spokeswoman said: "Our fear is that it will allow these hospitals, with all their freedoms, to effectively become private facilities. That is not in the interests of NHS patients."
The Department of Health said the government would respond to the amendment through the parliamentary process in due course.
But a spokeswoman also added that officials were carrying out a national audit of demand for unfunded drugs "to help inform our consideration of policy on the private patient cap in the future".
The usual half arsed policies from the Dept of Half arsed ideas, the answer is quite simple, supply the drugs under the NHS, then the “Prima-Donna” Foundation trusts can treat the patients.
“There is a simplicity that exists on the far side of complexity, and there is a communication of sentiment and attitude not to be discovered by careful exegesis of a text.” Patrick J Buchanan
Angus
Angus Dei on all and sundry
NHS Behind the headlines
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