A Birmingham hospital facing debts which could total £47 million is set to merge with the UK's top performing trust by the end of the year, it was revealed yesterday.
Heart of England NHS Foundation Trust, which runs Heartlands and Solihull hospitals, was brought in to manage struggling Good Hope Hospital in a bid to turn around the ailing hospital in November.
The hospital, in Sutton Coldfield, had been the first in Britain to be run by private firm Secta, but it could now become part of the Heart of England Trust by December.
Health Secretary Patricia Hewitt is expected to approve the proposed takeover next month, which will be followed by formal public consultation.
The trust will also present its business case for the "merger by absorption" to service regulator Monitor at around the same time.
Dr Mark Goldman, the trusts' chief executive, said it was the only way Good Hope could achieve foundation status. Otherwise it would be left with "a very serious problem".
He said: "We're putting forward a plan that will take Good Hope forward. This is not built around losing jobs or services, we're not about to suggest cutting the number of doctors or nurses.
"We are very keen for this deal to be signed and sealed by December 2006, which is a very tight deadline, but if it does not happen by then it will be completed before the end of the financial year.
"This is the only way Good Hope will be able to achieve foundation status, because it could not do that on its own.
"It can only do this by working with a third party. However, nothing is done until it's done, so I've got to recognise this might not happen.
"If it didn't we would not have a management contract with Good Hope and they would have a very serious problem on their hands."
While no major reconfiguration of services between Good Hope and Heartlands is planned, a number of disused or old hospital buildings on the Sutton site will be demolished.
It has already lost its mobile Vanguard operating theatre and up to 28 medical beds are set to be closed.
But there is no suggestion that 'big ticket' services, such as A&E or cancer care, will be moved during the merger.
"A&E at Good Hope sees about 75,000 people a year, and if we moved that where would they all go? But that's not going to happen, it's not an option," added Dr Goldman.
"We want to provide local services for local people across the three sites - Good Hope, Heartlands and Solihull."
The merger proposals come as Heart of England NHS Foundation Trust is investing £2.1 million on nurse recruitment and training, which Dr Goldman said was "a forever, not a one-off, plan".
"Good Hope is not currently capable of surviving without strong financial support from the SHA, but they will not continue to provide that support indefinitely," he said.
"That is why it's incredibly important to make this happen for Good Hope.
"But I have to accept that the DoH, Monitor, patient forums and the public have a right to agree or disagree with me.
"That's why I'm still using the word 'if'."