HEALTH bosses facing a £19m overspend last night warned that the biggest shake-up of services for decades is on its way in order to balance the books.

Christopher Long, chief executive of NHS North Yorkshire and York, said there needed to be a dramatic shift in NHS resources from hospital to community care.

His comments immediately sparked further concerns among campaigners fighting proposals to downgrade paediatric and maternity services at Northallerton’s Friarage Hospital.

Councillor John Blackie, leader of Richmondshire District Council, said the primary care trust’s finances were in “a very serious situation”

which would have “a detrimental effect” on health care services in North Yorkshire.

“The outlook for services at the Friarage would appear to be bleak if we are going to be saving these sums of money,” he said.

“You have to wonder what services are going to be left there if resources are shifted into the community.”

Mr Long said the alternative to changing the way services are delivered would mean saddling the new GP-led commissioning groups which take over most NHS budgets next year with even bigger debts, because any outstanding debts are subtracted from the following year’s allocation.

NHS North Yorkshire and York, the body that plans and purchases healthcare in North Yorkshire, revealed that it is expecting to finish this financial year with an overspend of £19m – not including the £22m efficiency savings demanded by the Government.

While plans are drawn up to regional health authority, NHS Yorkshire and Humberside, but this organisation is being abolished and the funds are no longer available.

The NHS in North Yorkshire has been dogged by debts for years and the situation has not been helped by its relatively low funding allocation per head of the population, the size of the county and chronic overspending on contracts.

This is in contrast with NHS County Durham and Darlington, which is predicting to end the financial year without any overspend and which has not received additional funding from the regional NHS.

Mr Long said the primary care trust, which has a budget of £1.25bn, was now developing what he described as a turnaround plan.

“The way services are currently delivered in North Yorkshire and York is not sustainable,”

he said.

The key change, he said, is to disinvest in expensive hospital services and re-invest those resources in improving NHS care in the community, redeploying more people into the community as part of “quite a radical shake-up” in how NHS staff worked.

“People spend too long in hospital because there isn’t anywhere they can go to that is safe. We are keeping people in hospital too long.”

Smaller community hospitals need to be used in a much more effective way to support people’s recovery, he added, saying further redundancies are probably not the way forward.

In a teleconference yesterday, Mr Long was asked whether acute services at the Friarage would be affected.

He insisted that the primary care trust and the Friarage “are in this together” and the priority had to be ensuring patients “have decent access to quality services that we can all afford”.

A consultation exercise is under way on controversial plans to close an overnight paediatric service at the Friarage, which would inevitably lead to the loss of a consultantled maternity unit and its replacement by a midwife-led unit.

A report on the trust’s finances will go before its board at a meeting on Tuesday.

restructure the NHS in North Yorkshire, there will be a renewed cost-cutting drive.

In recent years, the PCT has been bailed out by the