IT'S the price that must be paid for better health services in Southampton.
Just one year after mass job losses and bed closures, hospital chiefs in the city have revealed the axe will fall again.
A further 564 jobs will go at the city's three hospitals in the coming months, including forced redundancies of up to 100 staff.
A total of 140 beds will also be lost between Southampton General, Princess Anne and Royal South Hants as bosses try to streamline services and save cash by April 2007.
It's all for the benefit of residents in the city who are being promised a more efficient service when they visit hospital, says chief executive Mark Hackett.
The health chief has vowed that no front line positions will be abolished and that redundancies will mostly affect management, administration and clerical staff.
However, it's bitter news for an already furious union representing thousands of nurses, who say quality of care for patients will be compromised.
The plans were unveiled at a Southampton University Hos-pitals Trust board meeting yesterday.
Speaking to the Daily Echo, Mr Hackett said the latest cuts were in response to what patients wanted less time in hospital, fewer unnecessary outpatient appointments and faster discharges.
He also revealed that if the changes are not made, the trust would be spending money it didn't have resulting in a debt of £26m by the end of the financial year.
Mr Hackett said: "I think we have to do the right thing for patients, and what they want is for us to deliver better care. The changes we are planning will affect and improve that.
"These changes will not mean significant loss of employment more that people will be able to move to more exciting roles . . . We will not be making nurses redundant. We won't be cutting front line people."
Adding that 140 beds will also be lost, Mr Hackett said that would be possible as a result of working more efficiently.
"If we get better at reducing times for things such as length of stay in hospital, we need less beds."
He revealed there are currently 67 people stuck in hospitals in the city each day who should be at home, and better methods of discharging people will help ease the problem.
The latest cull comes at a time when Southampton hospitals are treating record numbers of patients more than 115,000 emergency and elective care patients, 80,000 in A&E and 370,000 outpatients in the past 12 months.
After one of the trust's toughest years last year, it has successfully slashed waiting times for surgery from six months to four, outpatient waiting times from 13 weeks to seven, and is meeting a government target to get people treated and discharged from A&E within four hours.
Its bid to break even comes as it is faced with staggering rises in energy bills mainly electricity which has soared by £2m in the past 12 months.
The cost of drugs has also escalated partly because of the increase in patients.
Mr Hackett said: "We are looking at energy efficiency, saving power from lights and computers and also the possibility of using solar power in the future.
"In terms of drugs, a record number of patients means our drugs expenditure increases. We will not stop offering certain drugs or cut back we would not compromise patient care but we will be looking at generic branded drugs, what their consumption is and what proves cost effective."
The bad news doesn't necessarily end here.
Plans for an independent treatment centre could see money which used to be given to SUHT taken away for certain services by 2007/08.
Mr Hackett said: "We could see some services moving out of the hospitals during 2007/08, and are projecting that there will be a deficit between what we are spending and what we are bringing in of around £7m, but we cannot say for sure yet because we don't know what will and won't be bought by PCTs in the future."
Mr Hackett denies accusations that the sums were wrong last year and these latest cuts could have been avoided, insisting this is a year-on-year task to enable the trust to live within its means.
"The trust and its staff last year responded to the challenges terrifically and reduced costs by £27m. I am ever so proud of that.
"I don't want panic and concern about our plans because there is no need for it. This is about giving patients what they want and I think we are offering a good deal both for patients and taxpayers."
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