Published: 06/12/2001, Volume III, No. 5784 Page 8 9

The chief executive of one of Scotland's largest trusts has admitted that mismanagement could be behind an overspend which will lead to job cuts.

Lothian University Hospitals trust has admitted running up a deficit of£1. 75m in the past seven months, including£552,000 last month. This comes on top of a£5. 2m deficit which had been revealed earlier.

Chief executive Allister Stewart conceded publicly last week that the financial report did not give anyone 'confidence', saying in a board meeting: 'The evidence would suggest bad management.

If there are areas of mismanagement, the responsibility lies with me and the general managers. '

But he later told HSJ that coments had been taken out of context and he was not behaving 'like a turkey voting for Christmas'. He added: 'I will be bringing a paper to the board...to show that there has not been mismanagement. We are facing significant pressures in a number of areas, including emergency care [and] delayed discharge, and, as a tertiary hospital, through providing specialist services. '

The trust, which is behind a flagship private finance initiative project to rebuild the Edinburgh Royal Infirmary on a new site, has announced that 135 jobs will be cut, including 41 nursing and 51 administration posts. While 75 of the posts are vacant, the rest will be managed by a combination of voluntary redundancy and redeployment.

The workforce reductions should make recurrent savings of£3. 4m. But this will not be enough to bring the trust into recurring balance.

Nor will the£4m one-off payment the trust received - part of a£90m Scottish Executive handout to NHS Scotland designed to 'wipe the slate clean'.

Finance director Aileen Brown, told a board meeting last week that the situation had deteriorated significantly in the past month.

The main problem had been with the surgical division, where activity had increased. But managers have warned that cutting elective surgery would have an impact on waiting lists, where the trust is already failing to meet its targets.

Mr Stewart said the job cuts were designed to minimise impact on frontline services: 'Over the past two years the trust has made savings of around£10m, with very little effect on staffing levels. We have spent a great deal of time examining all the options for achieving financial balance that are available to us now, and as staffing represents 70 per cent of our total spend it is unfortunately inevitable that posts have to go.

The Lothian situation is the latest financial trauma to hit Scotland's acute trusts.

Grampian, Tayside, Argyll and Clyde and Glasgow have all reported difficulties staying within budget, leading to calls for increased resources for acute hospitals, which have been the hardest hit by factors such as achieving compliance with the new deal on junior doctors' hours.

The number of patients on the waiting list in Scotland fell by 3 per cent in the last quarter.

Waiting times, however, were up - ironically just months after former health minister Susan Deacon announced the focus would be shifting from lists to waiting times.

Scottish National Party health spokeswoman Shona Robison said: 'These figures are for the summer period. If Labour can't deliver improvements over the summer, I shudder to think what will happen in our hospitals if we have a harsh winter or a flu outbreak. '