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Last Updated: Wednesday, 6 June 2007, 06:13 GMT 07:13 UK
Feeling the pinch in the NHS
By Nick Triggle
BBC News, Health reporter

The NHS has spent the last year making cuts in a bid to break even.

For many hospitals, this has meant shedding jobs and making unpopular decisions. But how does this affect services?

University Hospital of Hartlepool
Some 300 jobs have been lost

It was only 18 months ago that North Tees and Hartlepool NHS Trust was forecasting a deficit that was fast approaching 20m.

With a budget of 200m to run to hospitals in Hartlepool and Stockton plus a community centre in nearby Peterlee, the forecasts seemed pretty dire.

The situation began to be addressed in earnest in the autumn of 2005 when a new chief executive, Ian Dalton, was brought in.

Within months, it became one of scores of NHS trust to be brought under government monitoring through a turnaround director.

After a spate of cuts, the trust, which covers a local population of 400,000 in the north east, has emerged from the 2006-7 financial year with a 3m surplus.

The measures taken by managers are typical of those forced on many parts of a health service that has been under immense pressure from ministers to break even.

Some 300 jobs were cut from the 4,500 workforce - although much of this was through recruitment freezes and natural wastage and just five workers were made redundant.

Morale among staff at the trust, like the rest of the NHS, has suffered
Peter Chapman, of Unison

Other unpopular decisions have also been taken, although managers have avoided having to close wards.

Car parking charges have been increased, raising another 500,000, while the trust has reduced the amount of training it carries out, shaving off 300,000 from the bill.

There have even been allegations from the Royal College of Nursing that the trust was paying staff below the minimum wage, although officials maintained these were newly trained nurses who were on work experience.

Alan Foster, the trust's director of finance, said: "I would not say it has been pain-free. But we have managed to push through the programme without affecting patient care.

"We are still meeting all our targets and have become more efficient at the same time.

"We were overstaffed. People are staying in hospital for less time and treatments have improved.

"There are also better services in the community and this meant we had to reduce our workforce."

Morale

But despite the achievements in reducing the deficit, unions still believe there could be problems.

Peter Chapman, a regional officer for Unison, said: "We have concerns about the long-term consequences on patient care and the health and safety of staff.

"You cannot cuts posts without it having an effect. Morale among staff at the trust, like the rest of the NHS, has suffered.

"They feel their jobs are vulnerable and that does not make for a good working environment.

"There is understanding about why the trust has done what it has done and they have worked with us where they could, but it does not make it easy."


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