AN EMERGENCY £42m cost-cutting package has been put in place to save Chester's National Health Service from financial meltdown.
Now staff fear massive job cuts will be part of a recovery programme which has implications for emergency treatment, operations, mental health care and prescription drugs.
A Department of Health troubleshooter team has helped produce a plan which talks of 'medical staff reductions' and the possibility of redundancies at the crisis-hit Cheshire West and Ellesmere Port and Neston Primary Care Trusts (PCTs) which fund the local health service.
Job losses have not been ruled out at the Countess of Chester Hospital, which must tighten its belt as a consequence of the crisis plan.
The PCTs, whose financial management was slammed in an Audit Commission report, have already introduced internal economies but will be consulting on a £16m savings plan for the next financial year made up of:
* £10m hospital cuts - with £8.3m to be clawed back from the Countess
* £2m mental health cuts
* £1.8m reduction in the drugs bill
* £1m cut in PCT management costs
* £1.6m cuts in in-house services
* £500,000 cut in community care
Central to the PCTs' cost-cutting strategy is reducing the number of expensive admissions to acute hospitals like the Countess by helping more people to be cared for by their GPs, in an intermediate care facility or in their own homes.
Health chiefs argue the financial situation has forced a re-think which should lead to 'more appropriate' care.
Ellesmere Port Hospital must take its share of the savings, with the number of in-patient beds cut from 92 to 71 following a ward closure and a redefined role aimed at 'admissions avoidance and early discharge'.
Controversially, an expansion of private health care facilities is being considered.
A review is also being carried out into the PCTs' £19m-worth of land and buildings to see if they can be used more effectively.
The conversion of Cheshire West's 1829 Chester headquarters into apartments could be a long term option.