By James Clarke
BBC News, England
Unison, the trade union which represents many health service workers, has said debt within the NHS is having a serious effect on staff.
Unison said newly-qualified nurses were finding it hard to find jobs
A BBC News website survey has found health trusts across England are in a total of more than £1bn of debt.
A Unison spokeswoman said there were problems with posts not being filled and staff having to fill gaps left by a reduction in use of agency staff.
She said new government initiatives were putting more pressure on the NHS.
The BBC survey of NHS trusts, primary care trusts, mental health trusts and ambulance service trusts found more than half had deficits in January.
Many of the trusts said they had reduced the use of agency nurses as a cost-cutting measure, while others said they had made redundancies or were not replacing staff who left.
The Unison spokeswoman said: "We know there are problems around recruitment with posts not being filled and therefore newly-qualified staff not being able to find jobs.
"It is having an effect on staff who are having to fill gaps left by agency staff."
She said other cost-cutting measures were also causing problems.
"There have been ward closures and whole rafts of operations cancelled.
"Moving patients back into the community raises issues about who is going to take care of these people. You can't just move people out of a rehabilitation unit without giving them back-up care.
"Patients and staff are up in arms around the country where these proposals are being pushed through.
"Part of the problem is that the NHS has been under consistent pressure caused by the enormous number of changes the government dreams up and leaves to the trust to implement.
"You get situations where wards are being closed, staff are being threatened with redundancy, newly-qualified staff are unable to find jobs and yet the NHS is faced with another big project."
Other organisations to have recently voiced concerns at the debt, its impact or the way it is being dealt with include the Royal College of Nursing, the NHS Federation and the Patients Association
And a survey earlier this month by the Health Service Journal found 75% of NHS chief executives believed financial problems would affect patient care.
Health Secretary Patricia Hewitt announced on Wednesday 18 trusts with deficits would be given expert help to deal with their problems.
She said: "I have announced decisive action to turn around the minority of NHS organisations which have significantly overspent their budgets.
"The government will have trebled the investment in the NHS - and we are ensuring that every penny of extra cash is spent wisely for the benefit of patients.
"In a small minority of organisations there has been overspending, in some cases there's been inefficiency and in some health communities there's been an inefficient organisation of the way health services were provided.
"We are absolutely determined to put patients first.
"Improving financial management does not mean compromising services for patients."