A cash crisis at the Royal Cornwall Hospitals Trust is being blamed on a government funding formula which leaves West Country hospitals out of pocket.
The Royal Cornwall Hospitals Trust faces an £8.1m debt
The Trust, which operates Cornwall's main hospital, the Royal Cornwall in Truro, and acute hospitals in Hayle and Penzance, is cutting 300 jobs.
Wards and operating theatres are also to go as it faces an £8.1m debt.
The overseeing Strategic Health Authority (SHA) wants funding, based on local wages, to be readjusted.
The government's Market Forces Factor (MFF) formula assumes that it costs less to pay staff in rural areas and funding from the Department of Health is adjusted accordingly.
But most NHS staff are paid according to a nationally-agreed wage scale.
A 2004 report to the SHA revealed that Devon and Cornwall lost £100m a year because of the funding formula.
It said: "The overall scale of the MFF adjustment is significant and has a major impact on resource availability."
Liberal Democrat Truro and St Austell MP Matthew Taylor met then Health Minister John Hutton over the issue in 2004, and said he was promised a review of the system.
He said: "Local wage levels are about 25% below the national average.
"But health staff are paid on national pay scales, so the hospital does not cost any less to run.
"The hospital would be getting over £10m extra without the funding formula; there would be no debt, and these cuts would not be happening."
Barbara Hewett-Silk, chair of the Central Cornwall Patients Forum, said: "We have to pay the same wages as any other area of the country and we are penalised for that.
"I find it very worrying that the people of Cornwall are suffering because we do not get a fair crack of the whip from the centre."
A Department of Health spokesman said: "The job losses at the hospital are a local matter and not something that a minister would want to comment on."
The Trust, which has a budget of £232m, and employs about 5,000 people, has been ordered to save £9m by the SHA.
Chief executive Brian Milstead, said: "We have seen huge improvements in services, particularly around cancer and cardiac, but we can't make the scale of savings we need to make without it affecting staff spending."
Agency and temporary nursing staff would be reduced, but he said the majority of job cuts would be in management and administration. The details would be agreed with unions.
He said patient care would be unaffected.
He said: "We have to tackle infrastructure inefficiencies, but it is being done to protect patient care and give us a sound platform for the future."
Unison, which represents 1,500 workers at the hospital, said it would be fighting to avoid compulsory redundancies.