Consultants at Britain's largest trust have condemned private finance initiative plans that will mean the loss of 250 acute beds as 'a huge gamble with patient care'.
Leeds Teaching Hospitals trust will consult next year on proposals to build a trauma centre and unify services for cancer, paediatrics and obstetrics.
The strategic outline case - accepted by health secretary Frank Dobson as part of the 'third wave' of major health service PFI projects in July - also proposes some refurbishment of existing buildings.
But consultants at the 3,000-bed trust say the proposals are 'purely financially motivated' and designed to tackle a£4.3m deficit.
At a meeting of the senior medical staff committee last November, trust medical director Hugh Mascie-Taylor told doctors that the DoH had 'proposed a 500-bed reduction' - twice that now planned by the trust.
But chief executive David Johnson told HSJ 'specific bed numbers had not been quoted by the DoH', although 'the message was clear'.
He insisted the drivers behind the current proposals were 'largely clinical', although 'there will be financial constraints which will mean some of the clinical aspirations will not be met'.
Consultant anaesthetist Dr Steve Swindells questioned why beds were being cut on such a scale ahead of the publication of the government's national beds inquiry.
'They are shrinking the number of beds without knowing what the bed base is.'
He said the Leeds plans could bring a 'well-managed trust which is already under far too much pressure' to 'the brink of collapse'.
'We had a winter crisis last year when we didn't actually have a winter. It was a bit cold one day and the hospitals could not cope,' he said.
Mr Johnson responded by saying 'the thinking behind the beds inquiry' was 'an indication of support' for less drastic cuts in beds now proposed.
He added that 'our beds are under pressure at the moment' but saw delays in discharge, rather than increasing admissions, as the root of the problem.
The outline case promises 'alternative models of care' in the community to replace 150-180 medical beds for the elderly, which would be lost.
But senior lecturer in medicine and honorary consultant physician Dr John Wales said there was 'concern among the consultants that the changes may put unnecessary strain on our ability to provide services'.