More surgeons, nurses, and other frontline medical staff are in the firing line this morning after the announcement 800 jobs will be axed from two Midland hospitals.

Insisting patient care would not suffer, NHS boss John Adler said the move was vital to ensure the Sandwell and West Birmingham Hospitals NHS Trust stayed within its budget.

The trust, which is having to shed more than ten per cent of its 7,500-strong workforce as part of a #20 million savings plan, is the seventh NHS organisation in the region to announce job cuts. As reported in The Post, in the past few months proposals to cull more than 3,400 frontline and support roles across the entire Midlands have been revealed.

Yesterday, trust chief executive, Mr Adler, said the latest jobs to be culled - at Birmingham's City Hospital and Sandwell General Hospital in West Bromwich - were necessary to ensure the trust "lived within its means".

The first 300 jobs to be go, which will not include nursing staff, will be "removed" by July under a Supplementary Establishment Reduction Programme (SERP).

A second tranche of 500 jobs will be in 2006/7 and could see surgeons, consultants, nurses and other frontline staff leave. The cost-cutting plan also includes up to four wards - a total of 90 beds - two at each hospital.

In 2005/6 the trust treated more than 832,000 patients and, despite this latest swathe of job losses, Mr Adler was adamant a similar number would be cared for this year.

Staff will be invited to take voluntary redundancy or early retirement, but Mr Adler admitted he could not rule out compulsory redundancies.

"It would be fanciful to say there will be no impact on patient services but we will do as much as we can to minimise that," he stated. "Frontline staff could be going in the 500 job cuts, as there are some areas where we're not always working to capacity.

"Our nursing staff don't have any slack in their staffing levels, which is why they are exempt from the 300 jobs going under SERP. While we're not talking about stretching our staff to breaking point, we do have to make these savings.

"These changes will cause anxiety to our staff, but we have a duty to make the very best use of taxpayers' money and to live within our means."

The trust has imposed a freeze on filling vacant posts, as it expects to have less income in the next financial year. In 2005/6 it had #308.8 million, but that has fallen to #303.1 million for the following 12 months.

Mr Adler said this was due to a new national tariff paying it for each procedure, a #3 million deficit to be paid back from 2005/6, and a loss of other income. Last night unions and politicians rounded on the trust, claiming patient care was coming second to saving money.

John Hemming MP (Lib Dem, Yardley) called for Health Secretary Patricia Hewitt's resignation, claiming she had no idea of how the NHS should be run.

"Patricia Hewitt should do the decent thing and step down, and let someone competent take care of our national health service."

Ray Salmon, Unison's regional organiser, said: "We had been told to expect job cuts at City and Sandwell, but we were shocked to learn just how many would have to go.

"This is a trust which axed 200 jobs when it realised it had financial problems last year, but it doesn't seem to have tackled those effectively.

"I think a lot of people have been turning a blind eye to the NHS's financial problems for too long, which is why we're in this mess now."