NHS managers across the country are grappling with a looming financial crisis – too much demand and not enough money to go around. We know this.

The Government has rejected calls for extra help and instructed regional managers to balance their budgets. It has done this under the cover of so-called “sustainability and transformation” planning.

But the harsh reality is that the 44 regional NHS sustainability and transformation plans now underway are just a cover for cuts to balance the books. Nationwide, beds will disappear, A&E wards will be closed or downgraded and patients will have to travel further to receive the treatment they need.

This all sounds pretty grim, but perhaps we could understand the need for drastic action better if only the NHS – and the Government – were prepared to come clean instead of hiding behind meaningless locution.

In County Durham and across Teesside there is widespread concern over hospital services and what will be left after the books are balanced.

Despite promises of transparency and public consultation to date the process has been marked by obfuscation and an alarming degree of secrecy. The action of protestors yesterday, gatecrashing a meeting to which they had not been invited, is a reflection of the frustration ordinary people are feeling about this process.

We have no doubt that the clinicians working on this re-organisation are doing so with the best intentions and with the needs of patients uppermost in their minds. However, they can only do their best with the budgets they have been given to work with.

This shake-up will only succeed if the NHS can find a way to get the public on board and, to do that, it has to find a way of getting its message across more effectively.