Accountants will work with doctors and the trust
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A south London hospital is expected to be £20m in debt by the end of the financial year.
And the union Unison fears beds will closed or jobs will be cut at St George's Hospital Trust, in Tooting, as part of attempts to save money.
The trust says a team of accountants have been brought in to find ways to reduce the multi-million pound debt.
The hospital's former finance manager Ian Perkin said salaries were the only real area where savings could be made.
Mr Perkin, who claims he was sacked in 2002 after alleging the hospital was manipulating figures on cancelled operations, told BBC London: "St George's has an annual spend of just over £300m a year and the majority of that money is actually spent on salaries, the salary bill is about £175m a year.
Ian Perkin says St George's is an efficient hospital
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"So if you are going to make savings out of an institution like St George's it's got to come out of the staffing budget.
"So you are going to find the staff, who are already hard pressed and do a wonderful job, are under even more pressure in the future."
Mr Perkin said St George's was an extremely efficient hospital but blamed poor funding on the debt.
Unison fears Bolingbroke Hospital, on Wandsworth Common, which is part of St George's Hospital Trust, may be closed or have its services cut back.
A spokesman for St George's Healthcare NHS Trust said: "The latest forecast for the end of the year is an overspend of £20m.
"A team of accountants have been brought in to work with doctors and the trust executive to find ways to reduce it."