Manchester: Long wait for a dentist

People suffering toothache in Greater Manchester are still being forced to join long queues for treatment - three years after a government minister pledged to improve NHS dental treatment in the region - according to the Manchester Evening News.

Many are being forced to wait in hospital after failing to find an NHS dentist who can give them an appointment.

In September 2004, health minister Rosie Winterton promised dental care would improve after we showed her the queues of desperate patients outside the dental hospital.

But the lines of desperate patients are still there, and an exclusive survey conducted by the MEN this month has revealed that only a quarter of NHS dentists in Greater Manchester are offering NHS treatment to patients who say they have a painful dental problem.

Despite the freezing weather yesterday morning, patients had chosen to queue at the hospital on Oxford Road rather than face the expensive fees of their dentists who have converted to private practice.

Terrible toothache Alani Mosharaf, 31, a student from Chorlton upon Medlock, was first in the queue, he said: "I've got terrible tooth ache, I don't know what is wrong, I've had problems for the last four months and I've been here several times.

"I've tried to get a dentist near my home since I arrived in the city three years ago but they are all private, they are not interested in NHS patients - it seems like there is no NHS any more where I live."

Ben Cousins, 21, a restaurant manager, from Hulme, was also in agony but he queued for more than an hour because his last visit to his - now private - dentist cost him more than £100.

He said: "I can't afford it in November with Christmas coming up, I'm not looking forward to having a tooth removed and I don't want to pay that much to have it done.

"They say it costs £14.50 here for an appointment and depending on what you have it can go up to £48, which is a lot better value."

Last year we reported how two new full-time dentists had been recruited to work at the hospital enabling the clinic to see up to 80 extra patients a day but it still hasn't reduced the queues.

Patients are supposed to be able to get dental treatment on the NHS without being registered with a dentist. But when an MEN reporter rang 50 dental surgeons complaining about a chipped tooth just 13 said they would offer an NHS appointment within a month.

Our reporter was told by 21 of the dentists that he could have treatment privately.

The remaining 16 dentists could not offer an appointment at all, either privately or on the NHS.

The dentists were registered in the "find a dentist" section on the government's NHS Choices website.

The findings of the MEN's study are to be presented to a committee of MPs later this week by Dr Anthony Halperin, the chairman of the Patients' Association who is also a dentist.

He believes lack of funding for NHS dentistry from Primary Care Trusts is at the root of the problem and said: "It does show there are problems gaining access to NHS dentists.

"That is not necessarily because dentists are choosing to treat private patients before NHS patients, but because they are not getting funding from the PCT to take on new NHS patients.

"Under the old system, dentists could take on as many NHS patients as they liked and then fill out forms for funding. But now the funding must already be in place from the PCT and that is causing problems.

"That is what has come across to the Patients' Association. It is the lack of funding, rather than a lack of space or capability.

"These are interesting findings and I'll mention the survey when I speak to MPs next week at a select committee."

All dentists now work on a self-employed basis, and receive funding from the Manchester PCT for treating NHS patients. As more dentists turn from treating NHS patients to private work, many are now branching out into cosmetic dentistry.

When our reporter rang the same 50 dentists and asked whether they could do teeth whitening - a private cosmetic service costing between £190 and £550 - more than two thirds (34) of them said they did and offered an appointment.

A spokesman for the Manchester Health Watchdog said it was a concern that most NHS dental practices are still running a registration system despite the new guidance from the Department of Health. The watchdog was also aware practices were asking patients to sign up to monthly direct debits to receive treatment.

Martin Rathfelder, member of the Manchester Health Watchdog, said: "It is a difficult situation because dentists are self-employed and there isn't any way of preventing them doing cosmetic work, but I think questions should be asked of Manchester PCT about the level of capacity of NHS dentistry in the city.

"Based on the information collected by the MEN, the PCT should be ensuring that all NHS dentists in the city are meeting their dental unit targets and if they are not, why not?

"Is capacity the issue or is it about the money.

"Most of the dental practices in Manchester seem to be running a practice list system. Is that lawful?"

Graham Stringer, Labour MP for Blackley, said: "It seems since the new system was introduced more dentists are choosing to take on more private work.

"The current system isn't delivering what it promised to in many parts of the country, although the situation in my constituency isn't as bad as in other parts of Greater Manchester and elsewhere.

"It needs to be looked at again because the tax paying public is not getting value for money and there are real flaws in the new arrangements.

"The balance is not there. Dentists are choosing to take on more private work and this is limiting the number of NHS patients they can treat."

Manchester: MP defiant over hypocrisy claims

Health minister Ivan Lewis has denied he is a hypocrite after supporting a shake-up which includes the closure of a maternity unit he campaigned to save - reports the Manchester Evening News.

Last year, the Bury South MP joined a march aimed at keeping full maternity and children's in-patient care at Fairfield General Hospital.

But he has now backed the decision of an independent panel to close four of Greater Manchester's 12 maternity departments, including Fairfield.

Mr Lewis called criticism a smear campaign and said it was unfair and untrue because he has always accepted doctors' arguments that the current system was unsafe.

He said that although he believes there is a strong geographical argument in favour of a full service for children at Bury, his constituents will benefit from the £60m investment that comes with the shake-up.

Shadow Health Secretary Andrew Lansley claimed Mr Lewis had bowed to pressure from Gordon Brown to back the cuts.

He said: "This is an incredible U-turn by Ivan Lewis. Only a few months ago he was campaigning to save his local maternity services. Ivan Lewis has been squeezed by Number 10. Either that or he is indecisive in the extreme."

Maternity units in Trafford, Rochdale and Salford will also close by 2011 because of a shortage of specialist staff.

Sharron Entwhistle, from Fairfield Baby Lifeline Society, which led the support for the unit, said: "Ivan Lewis has supported us and we are grateful for that - as a result of our campaign we have won concessions.

"I don't think he is a hypocrite but as a health minister he should have a lot of influence and we believe he could have done more to help - whether he could have made more of a difference, who knows?"

Manchester: Hospital closures and cuts 'will cost lives'

Plans to downgrade A&E and maternity services in Greater Manchester were approved yesterday amid claims the changes will cost lives - reports the Daily Telegraph.

Under the plans approved yesterday by an independent panel and Alan Johnson, the Health Secretary, Rochdale Hospital's maternity and in-patient paediatrics services will close.

Its A&E will be downgraded to an urgent care centre and emergency surgery will be moved out.

Tens of thousands of people signed a petition against the closure of the maternity unit.

Fairfield Hospital in Bury will lose its maternity service, inpatient paediatrics and emergency surgery although A&E will remain.

In Salford, maternity and inpatient paediatrics services at Hope Hospital will close and its neonatal intensive care unit will move to the Royal Bolton Hospital. Trafford Hospital will lose its maternity services and inpatient paediatrics.

Managers say the changes will ensure patients are treated safely, but Paul Rowen, the Liberal Democrat MP for Rochdale, accused Mr Johnson of "wielding the axe" in Greater Manchester.

"The Labour Government ought to be ashamed of themselves. This decision by Mr Johnson will cost lives," he said.

Hazel Blears, the communities secretary and Salford MP, said she was "pleased" by the recommendation that Salford should have a stand-alone midwife-led unit.

In December, she was accused of hypocrisy after joining picket lines to protest over the proposals.

Manchester: Midwives 'dismayed' at fewer units

Midwives have condemned the decision to cut maternity and children's care from 12 to eight hospitals in Greater Manchester and challenged health chiefs to reveal exact bed numbers - reports the Manchester Evening News.

Senior figures in the Royal College of Midwives are "dismayed' by the plans, which will mean babies will only continue to be born in hospitals in Trafford, Salford, Bury and Rochdale after 2011 if health chiefs decide to set up stand alone midwife-led units.

The RCM claim health chiefs `got their sums wrong.' Politicians in Bury, Trafford and Salford have also reacted angrily to the cuts.

But health chiefs defended the plans, saying they would create more beds and improve safety. There were no exact bed numbers available.

Dr Maria Barrell, director of the Royal College of Midwives, said she was speaking out against the plan to protect women's safety.

She said: "I am very concerned that the reduced capacity of Greater Manchester's maternity units will not be able to cope with the demand of an increasing birth rate.

"Midwives are already struggling to provide the quality of care that patients expect and deserve. The government says that extra investment will compensate for the closures, but it seems to me they're got their sums wrong."

Leila Williams, director of the Children, Young People and Families Network, the organisation behind the maternity review, said: "There will be more beds after these plans are brought in. The whole point of Making It Better was to improve the safety for women and children's services across the region."

Health bosses in Bury, Salford and Trafford are now considering the option of midwife-led units.

Edna Robinson, the chief executive of Trafford Healthcare, said: "We are obviously still disappointed that our services will alter. However we do still understand and support the principles of the changes.

"We are very excited by the prospect of establishing a Birth Centre at Trafford General."

Margaret Morris, Chairman of Salford Royal, said: "We are bitterly disappointed with this news.

"We have a track record in delivering high quality care through our maternity and neonatal services."

Coun Yvonne Creswell deputy leader of Bury Council said: "The decision to downgrade the maternity unit is devastating for all those people who fought so hard to keep it open.

"It will deny thousands of Bury resident's access to local maternity services and is nothing short of betrayal."

MP's back Wilson's drug plea

Two Manchester MPs are backing a campaign by music legend Anthony Wilson to persuade local health bosses to provide a pioneering cancer drug on the NHS - reports the Manchester Evening News.

Mr Wilson - known as `Mr Manchester' - was denied a new drug for kidney cancer called Sutent on the NHS and is now paying for the £3,500-a-month treatment with the help of friends.

Sutent has doubled the life expectancy of some patients in trials but is still being assessed for use across the NHS so individual health trusts are deciding on a case-by-case basis if they wish to fund it.

Two patients being treated alongside Mr Wilson at the Christie ARE receiving funding for the therapy because they live a few miles away in Cheshire, where a much higher proportion of patients are being funded.

Health bosses in Cumbria have also decided to fund the treatment for their patients, some of whom are cared for at Manchester's Christie Hospital.

Graham Stringer MP for Manchester Blackley and Tony Lloyd MP for Manchester Central have written to Manchester Primary Care Trust to ask them to pay for the drug until the Government watchdog decides whether Sutent should be provided nationally.

The letter reads: "We are writing to you following reports in the Manchester Evening News that a number of patients in Greater Manchester are not being allowed to be treated with the kidney cancer drug called Sutent, although we understand patients from Cumbria and Cheshire are receiving this treatment.

"We consider this to be completely unacceptable and would ask you to review this policy."

Health bosses say they have to make very difficult decisions in order to provide the best care for patients and have good procedures in place to look at the effectiveness of new drugs.

The M.E.N. has learned that in the last 16 months PCTs in Greater Manchester have turned down eight requests for Sutent backed by doctors at the Christie and approved one, while Central and East Cheshire PCT have turned down one patient and approved two.

Four people who were refused treatment with the new drugs on the NHS , including Mr Wilson, are paying privately.

He said: "I want to know what has happened to the 11 people who can't afford to pay for treatment.

"I want to know what their lives are like now, have they been sentenced to death by this decision? It is a scandal."

Manchester NHS Primary Care Trust, which has refused to pay for Mr Wilson's treatment, says there is not enough `demonstrable evidence to support the use of this drug in treating kidney cancer.'

But Prof Robert Hawkins, a kidney cancer expert from Christie, believes the refusals come down to cost - even though he estimates the total bill if Sutent was routinely available on the NHS would be £2m a year for Greater Manchester.

He said: "There is no doubt it would be available if it was cheap. I will now be able to prescribe Sutent to patients from Cumbria but not routinely to anyone else - which puts me as a doctor in a difficult position.

"I am delighted local MPs have asked the PCTs to look again at this issue. The PCTs in the north east looked at the best available new evidence and cost-effectiveness data taking full account of recent price reductions and accepted it was a cost-effective treatment. I would urge the Manchester PCTs to look again at this fuller information."

Tony Lloyd said: "If someone living a few metres over the border into Macclesfield can have this treatment but someone living in my constituency cannot, it can never be acceptable."

When the medical experts, in this case senior doctors from the Christie who are certainly regional experts and is some cases nationally and internationally renowned, recommend a treatment for a certain condition we have to take that seriously."

Graham Stringer said: "We are asking them to reconsider, this is not a maverick treatment, it is recommended by doctors and some patients are already being treated with it."

We contacted Manchester PCT but they said they were unable to comment on the letter because it raised issues involving health trusts across Greater Manchester.

Previously Shauna Dixon, clinical director for Oldham PCT, which is leading Greater Manchester cancer drug commissioning, said: "Every effort is made to make sure the best care is provided to patients.

"All NHS trusts give careful consideration to the very difficult decisions they make when they look at individual cases to make sure they safely meet their medical needs. A clear framework is used to ensure there is good evidence to demonstrate a drug is effective."

Bolton: Canal repair under threat

Improvements to the local canal network are in jeopardy because of cuts to Government funding - reports The Bolton News.

Regeneration work on the Manchester, Bolton and Bury Canal is described as being at risk as British Waterways prepares for a £35 million shortfall in Whitehall funding by 2011.

A report from the Parliamentary Environment, Food and Rural Affairs Select Committee voices "extreme concern" about the scaling back of public funding to British Waterways, which is responsible for 2,200 miles of rivers and canals nationwide.

John Fletcher, chairman of both the Manchester, Bolton and Bury Canal Society and the International Waterways Association, said: "This report identifies the elements that government needs to address - one of which is the threat to waterway regeneration by funding cuts.

"Money is tight but these canals fulfil many government objectives such as educations, green routes, healthy living and jobs.

"The Manchester, Bury and Bolton Canal has always depended on third-party funding but British Waterways needs the cushion of funding which Defra is depriving it of.

"I look forward to working with Defra and British Waterways to work out a new architecture of funding to resolve current problems."

Mr Fletcher will meet with senior civil servants later this week.

British Waterways is already under pressure after shortfalls forced it to scrap £5.6 million of planned refurbishment work on stretches including the Ribble Link, which joins the Lancaster and Leeds-Liverpool canals via the River Douglas.

Waterways Minister Jonathan Shaw said: "We will now work with British Waterways closely in carefully considering the committee's recommendations, but I can say that I am committed to ensuring there is good communication and effective working relationships between Defra ministers and officials at British Waterways."

The committee called for the National Audit Office to review conflicting claims about the state of British Waterways' finances.

Manchester: Trusts fail hygiene targets

Seven NHS trusts in Greater Manchester are failing to meet key targets aimed at tackling bugs like MRSA, reports the Manchester Evening News.

Manchester Primary Care Trust, North Cheshire Hospitals and Stockport PCT all failed to show they are meeting two hygiene standards.

Trafford PCT, Heywood, Middleton and Rochdale PCT, Bury PCT and Warrington PCT had not met, or cannot provide enough evidence to prove they are meeting the standards.

Standards include properly decontaminating reusable medical devices, such as theatre instruments.

Nationally, one in four NHS trusts are failing to hit the minimum standards for hygiene.

The news comes just weeks after the Healthcare Commission warned that failing hospitals will be served with `improvement notices'.

Today's report, issued by the Commission, is based on trusts self-reporting on whether they meet a set of 24 core government standards on care.

A total of 55 trusts including Manchester PCT and North Cheshire Hospitals had not met, or could not prove they met the standard on keeping patients safe by reducing the risk from infections like Clostridium difficile.

Forty-three trusts, including Stockport PCT and Warrington PCT, had not met, or had no data to show they met the standard on areas being clean and buildings being in good order.

A spokesperson for Manchester PCT said: "Achieving compliance is an on-going priority for the PCT.

"We have allocated additional resources and put action plans in place to ensure progress is made and monitored in those areas where we did not declare full compliance this year."

Manchester: Hospital bed cuts plan revealed

About 10% of beds are to be cut across four Greater Manchester hospitals to help an NHS trust balance its books - reports the BBC.

Staff at the Pennine Acute Trust were told of the plans to cut 221 of its 2,279 beds at a meeting on Tuesday.

The trust runs Fairfield General Hospital in Bury, North Manchester General, the Royal Oldham Hospital and Rochdale Infirmary.

Royal Oldham will lose 69 of its 703 beds; 60 beds from a total of 664 to go at North Manchester; Fairfield Hospital will lose 55 of its 518 beds; 37 beds lost out of Rochdale's 394.

Pennine Acute Trust was £28m in debt last year and the bed cuts are part of a number of measures on its "recovery plan".

The Royal Oldham Hospital will lose an 18-bed surgical unit and 12 of 28 beds on an orthopaedic ward.

At North Manchester the cuts will include the closure of a 20-bed short-stay ward.

At Rochdale, a medical ward will be lost and at Fairfield an orthopaedic ward will be cut from 22 to 12 beds.

Roger Pickering, director of human resources and organisational development at Pennine Acute, said: "Our aim is as before, to deliver financial recovery, while minimising the impact on patient services and staff."

Rossendale: 'Don’t stamp out our post offices'

The future of a number of Valley post offices has been thrown up in the air following the government's announcement that around 2,500 branches will close in the next two years - reports the Manchester Evening News.

Postmasters across Rossendale face an uncertain future following Trade and Industry Secretary Alistair Darling's Commons announcement last Thursday that a fifth of the nation's network is to close.

A clearer picture should emerge following meetings between Valley postmasters and the Post Office Ltd pegged for the coming months.

Mr Darling argued that new technology and changing lifestyles were resulting in the entire network running with unsustainable weekly losses of £4M.

But Jackie Oakes, of Stacksteads Post Office said that, despite systematic changes in services such as pensions, her business had never been more vital.

She said: 'I'm still as busy as ever; we were a bit surprised as we thought that we would be less busy when the pension books went but I think people are more aware now of the banking services we offer and they make a point of supporting the Post Office service.'

There will be around 60 area-specific proposals conducted before a period of public consultation is launched; the final decision will be made by Post Office Ltd.

Jackie explained that Valley postmasters were currently in the dark over what would ultimately happen and were nervously awaiting news from the parent company.

She added: 'Basically all we know is that if they keep to the three-mile distance rule between post offices they could close us, Lea Mill and Britannia and that will be a catastrophe.

'The timescale is the next 18 months, but 18 months ago when they said they would close 2,000 post offices there was such a furore that they had a public consultation, yet here we are now and they are saying the same thing.

'All the postmasters have been invited to a meeting in the middle of June, when they may learn more, but at the moment there is nobody we can contact to clarify anything, so we will just have to wait until then.

'On a personal level, I live on the premises so this is really important to me.'

If government subsidy cuts cause local post office closures, can local MP Janet Anderson really justify approving paying the EU an extra £2.5 billion every year - much more than would be needed to keep local lifeline post offices open?

That would hardly be a responsible course of action on behalf of her constituents. Especially since the EU hasn't been able to get its accounts approved by auditors for twelve years in a row, so we're unlikely to find out how the majority of that £2.5bn extra EU payment gets spent.

Only holding her seat by a highly marginal 3,676 votes, Ms Anderson had better consider very carefully how voting to approve the EU budget deal would look to local voters denied essential public services that could have been saved with a little more financial support.

Manchester: New debt crisis hits health trust

Mental health services in Manchester have been placed on the government's critical list - reports the Manchester Evening News.

Cash-strapped Manchester Mental Health and Social Care Trust which started the financial year £4.5m in debt, will have to report its financial progress to regional health bosses every fortnight.

It is the second trust in Greater Manchester to officially enter "turnaround" - a Department of Health initiative to tackle debt crisis.

MMHSCT, which has a historic debt of £1.9m and is already predicting it will be £2.5m in the red by March next year, will have to appoint an outside troubleshooter to find ways to cut spending and make savings.

New chief executive Sheila Foley said: "While we are disappointed with the decision, we are determined to use this opportunity to put the Trust into sustainable financial stability.

"We remain committed to delivering the agreed improvements to mental health services across the city."

The turnaround programme was started by the Department of Health 15 months ago.

Turnaround trusts have to produce detailed plans of how they will provide patient care and bring their finances in line.

The city's mental health services are set to undergo radical changes after a public consultation called Change In Mind.

Karen Reissmann, of the MMHSCT staff union's forum and a top member of Unison's executive, said: "Mental health nationally and certainly mental health in Manchester has been under-funded for many years, despite the obvious high need.

Manchester: Hospital beds axe fear

Staff at North Manchester General Hospital are 'demoralised', according to their hospital union, as trust bosses look to cut dozens of beds to trim a £12M debt - reports the Manchester Evening News.

Negotiations between Pennine Acute Trust managers and hospital staff continue over 60 bed cuts at the Crumpsall hospital over the next year, just as a Healthcare Commission report finds that a third of patients across Pennine Acute Trust's (PAT) four hospitals already have to share wards or bays with people of the opposite sex.

Some 29 beds on North Manchester General's short-stay surgical unit could be first in line to be axed, along with 14 beds at Royal Oldham.

Unison's Pete Hinchliffe said: "We are opposed to all the bed closures because we cannot see that it is anything but detrimental to the services - it is driven purely by finance.

"We are in discussions with managers about plans for surgical bed cuts in Oldham and are now speaking to staff at North Manchester.

"Staff need to know where these job cuts will be as soon as possible. It is unsettling and demoralising for them to have the cuts hanging over them like this."

Trust bosses have confirmed that managers are considering where to make the cuts which they claim form part of a package of 'improvements', but say no final decision has yet been made. Staff affected by the changes would be offered other jobs with the trust.

Roger Pickering, a PAT director, said: "Decisions have not been made to close specific wards. As we announced previously, our recovery programme involves reducing a number of beds from each site.

"We've asked staff in our operational divisions to work up proposals for each site, so there will certainly be ideas in the system, and discussions across all of our sites. However, this is different to formal proposals agreed by the trust.

"We are not at that stage - once we are then staff will be informed. We have been very open about reducing bed numbers, and the need to engage staff in developing the proposals so that we get this right."

Nurse redundancy figures revealed

Twenty-three hospital nurses were made redundant in the North West in the last six months, reports the BBC.

As well as the nurses, 113 managers, 29 clerical workers, seven therapists and two healthcare scientists also lost their jobs, NHS North West said.

On Monday, the Royal College of Nursing (RCN) claimed about 22,000 UK posts had been lost because of NHS cuts.

Speaking at the RCN's annual conference, Dr Peter Carter, general secretary, said the NHS was having the "life squeezed out of it" by deficit-imposed cuts.

The figures released by NHS North West concern the actual number of people made redundant since October 2006, rather than NHS posts.

The health authority said some redundancies in Greater Manchester were as a result of the move towards more community-based services.

Others were through some hospitals making efficiency savings as part of a drive to become financially stable, it said.

By the end of February 2007, a total of 174 staff out of 203,456 in the NHS in the North West had lost their jobs.

NHS North West covers 66 hospital and primary care trusts in the region.

Hundreds of NHS staff march against job cuts

Hundreds of health workers took to the streets to protest at cuts to NHS jobs and services, reports the Manchester Evening News.

Campaigners - protesting against the government for slashing budgets - marched through Manchester and staged a rally in Albert Square.

It was part of a national day of action by the NHS Together alliance of unions and other organisations.

Karen Reissman, chair of the Manchester branch of Unison for community and mental health services, warned the crowd of about 400 that the NHS was under threat.

She said: "In a few years time we won't have a National Health Service to defend, unless we act now.

"The scale on which the NHS is being attacked is unprecedented. It isn't as if Britain isn't a rich country and can't afford a decent NHS. It most certainly can."

The action was also in support of 250 mental health workers who have been on strike over cuts in jobs and services, downgrading of jobs and threats of privatisation.

Lillian Elliot, a union rep in the national blood service, said it was facing the threat of nine blood processing and testing centres being reduced to just three.

She said: "If this comes to pass, we will see vital blood supplies spending most of their time on a motorway."

Angela Murphy, a senior radiographer at Hope Hospital in Salford, said staff face having to work two-and-a-half hours a week more while pay increases are less than inflation. She said: "We are also facing the possibility of redundancies and there are lot of very angry people within the profession."

TUC general secretary Brendan Barber sent a good luck message to the organisers saying: "I know that NHS staff in Manchester take real pride in the improvements in health care delivered in recent years."

An NHS Together banner was raised at the peak of England's third highest mountain - Skiddaw in the Lake District - to support the day of action.

Manchester: Trust to cut 10% of staff, pushing NHS job losses to 10,000

The largest NHS trust in the north-west of England announced plans to axe nearly 10% of its staff yesterday in an attempt to eliminate a £21m deficit - reports The Guardian.

Pennine Acute trust said it would remove 800 posts at its hospitals in Bury, north Manchester, Oldham and Rochdale - one of the largest job losses to emerge since the NHS went into a period of retrenchment two months ago.

The public sector union Unison said it was a disgrace that the cuts had been announced without any consultation with staff representatives. Nurses heard that their jobs might be at risk from the radio while eating their breakfast.

Manchester: Job cuts at four more hospitals

The NHS health trust which runs four Greater Manchester hospitals could axe up to 800 posts as it struggles to cope with a deficit of £21m, reports the BBC.

The cuts would be made by Penine Acute Trust at North Manchester General, Royal Oldham, Rochdale Infirmary and Fairfield General Hospital in Bury. C

ompulsory redundancies are not being ruled out, but the trust said this would be a last resort.