Patient services and jobs are at risk as London trusts face a £75m cash crisis, figures obtained by HSJ show.

The true shortfall could be even higher, as calculations for mental health trusts and many community trusts are not included. A total deficit of up to£100m is being discussed by health authorities across the region, insiders claim.

Pressure group London Health Emergency said figures obtained from HA board meetings showed a debt of at least£74.74m to date, covering 23 acute and community trusts. The figures are based on debts for the financial year just ended and projections for the year ahead.

Information officer John Lister said: ‘If you look at mental health trusts and the trusts for which we have no figures yet, you would be closer to£100m.

‘They have been told to balance the books by the end of this financial year, but it is hard to see how they can do that without clamping down on services and staffing.’

Acute trusts alone were more than£60.8m in debt, Mr Lister said. This sum does not include the Lambeth, Southwark and Lewisham HA area where figures for trusts were not available.

Health analyst Nigel Edwards, director of the London Health Economics Consortium, said the amounts were ‘not uncommon’ for London, but projections could change for 1999-2000, as could the final figures for the financial year just ended.

Trust and HA chief executives were ‘caught in the middle’ of competing demands from ministers to keep waiting lists down, maintain patient services and balance the books, he added.

Trust chief executives said the figures would be brought under control. Andrew Dillon of St George’s trust in south London said the suggested sum of£5.6m for his trust ‘didn’t bear any relation’ to the last financial year or negotiations for this one. But he has admitted that St George’s is facing ‘cost pressures’ of£6.7m.

The NHS Executive London regional office also disputed the figures. A spokesperson said budgets for 1999-2000 were ‘still being finalised’, but it expected the position to be ‘similar’ to 1998/99. ‘HAs and trusts across London are overspending by a total of about£25m,’ she said - only 0.5 per cent of the budget for healthcare in the capital.

But insiders say the London region is under pressure to reduce the total deficit to£45m this financial year and to£25m in 2000-2001, implying major cuts.