A man who repeatedly subjected NHS staff to verbal and physical abuse has today been banned from every hospital and doctor's surgery in the country.

Norman Hutchins, 53, becomes the first person to be placed under an antisocial behaviour order (Asbo) banning him from entering or calling NHS premises and private clinics in England and Wales.

York Magistrates' Court heard that Hutchins's anti-social behaviour had became progressively worse and that in the past five months he had verbally or physically abused NHS staff on 47 separate occasions.

The magistrates were told that Hutchins, of Rowntree Avenue, York, had a fetish for surgical masks and would contact NHS organisations to get them. He would often claim that he needed them for amateur dramatics or that he was doing a fun run in fancy dress.

Mr Justin Crossley, prosecuting on behalf of York City Council, said that Hutchins's behaviour went back 15 or 16 years.

The case marks a new front in the campaign to target violent offenders, who will now face a "three strikes and you're out" policy.

The strategy will see any patient who acts aggressively immediately cautioned. Those who commit physical violence will be prosecuted, while serial offenders will be subject to a banning application.

Hutchins, who is unemployed, was targeted by NHS security services after the full extent of his behaviour emerged. Mr Crossley outlined to the court specific incidents of harassment to members of staff.

He told the court that on January 27 Hutchins entered a dental surgery in Selby requesting medical masks. After obtaining a mask, he asked a member of staff to put it on and then take it off.

Mr Crossley added: "The allegation on the part of the council is that his behaviour thereafter became inappropriate and sexualised. He requested a member of staff to tie it and he was seen to have an erection."

On January 29 Hutchins is alleged to have entered the A&E department at York District Hospital where he became verbally abusive to members of staff and produced a knife.

Magistrates were told that some of the allegations against Hutchins have yet to be proved and his solicitor, Harry Bayman, said he denied some specific points.

But Mr Bayman said his client was prepared to agree to the interim order. He said: "The problem with this order is this gentleman, as with anyone else, may suffer health problems in the future and may require medical treatment.

"In any layman's opinion, he is not a well man and is almost bound to need medical treatment in the near future."

If Hutchins has a genuine need of healthcare, he will be required to get written permission or must attend the NHS in accordance with strict instructions on his behaviour. Should he break those conditions, he would face up to five years in prison.

The case will be heard once again at York Magistrates' Court on June 30. In the meantime, Hutchins is due to be sentenced at York Crown Court next week on further counts of harassment and obtaining property by deception. He has previously served a six-month jail term for deception after duping hospitals into giving him surgical gloves and masks.

Before today's order was made, Hutchins had avoided breaking civil injunctions brought against him by several hospitals by moving between health trusts around the country. He is known to have had contact with more than a dozen NHS trusts in recent months, as far afield as Devon and Dundee.

Jim Gee, chief executive of NHS Security Management Services, said that the application for a national ban signalled a zero-tolerance attitude to violence in the health service.

"It is very sad that this sort of thing is necessary, but with rights to free healthcare which we have in this country come responsibilities. The vast majority of patients and members of the public want to protect the NHS and patient care," Mr Gee said. "Unfortunately there is a minority who do not respect the NHS and it is our job to prevent assaults and violence against staff.

"The NHS really is a privilege for people and, if you abuse that privilege, then it will be taken away."

More than 116,000 incidents of physical aggression or verbal abuse against NHS workers were reported last year in England and Wales, up 8,000 on 2002. But only 50 of the cases resulted in prosecutions, mainly due to legal loopholes in the definition of physical and verbal abuse.