Four months after it was revealed how much Midland health trusts had paid into the NHS Bank and who exactly was benefiting, the financial forecasts make for grim reading.
As the region's debt-ridden hospitals and primary care trusts (PCTs) predict deficits totalling £74.6 million for 2006/07, it appears affluent trusts are now struggling, after bailing out ailing organisations.
However NHS West Midlands, the strategic health authority, predicted it will achieve a surplus of £65 million. Last year it had an extra £50.8 million in its coffers.
The Department of Health drew up plans for the NHS Bank in January, into which Midland trusts deposited, in total, £187 million, money to be loaned to crisis-hit trusts.
PCT budgets were "top sliced" by, on average, three per cent to fund the bank's loans, at the start of this financial year.
A dozen organisations across the region have been earmarked for loans ranging from £4 million to £37 million, which must be paid back over four years at an interest rate of 4.5 per cent.
University Hospital North Staffordshire got the largest pay-out of £37 million, while Royal Wolverhampton Hospitals received £16.3 million. Both are predicting they will break even.
But elsewhere Coventry Teaching PCT, which previously reported a deficit of £3.79 million is braced for debts soaring to £10.5 million and last month announced it was axing 90 jobs to make urgent savings.
A trust spokesman said: "Despite good progress being made against our savings plan of £29 million for 2006/7, new pressures relating to commissioning of acute services, prescribing and community care have contributed to a fore-casted year end deficit of £10.5 million. We will be discussing this position at the November meeting of our board."
Health bosses in South Worcester were £11,000 in the black last March, but now they are set to be £10.1 million in debt by year end. Shropshire County PCT is also in a similar position as its £732,000 surplus is set to become a £4 million deficit in six months.
Glen Burley, chief executive of South Warwickshire General Hospitals NHS Trust whose debts may top £12 million, admitted it was relying on a £10 million loan.
Hospital bosses there have already closed wards, losing a total of 60 beds and 130 staff through "natural wastage" at Warwick and Stratford-upon-Avon hospitals.
Mr Burley said: "Our projected deficit has fallen to £11.8 million since September and we're working to get that down to £10 million, so that we receive a £10 million loan from the NHS Bank which means we can break even by year end.
"We've not announced any job cuts to achieve this and we're not going to make any compulsory redundancies.
"Yes we have reorganised our capacity to lose 60 beds, mainly in general and surgical wards, and redeployed staff.
"Through natural wastage 130 people have left the trusts in the past six months, through changes in clinical practice such as more day surgery and reducing length of stays."
Last night Cynthia Bower, chief executive of NHS West Midlands, said: "The current projected deficit represents just 0.5 per cent of the £6.5 billion spent on local health services in the West Midlands.
"We are confident that, with management action, local organisations can improve against their forecasts deficits and that there is sufficient opportunity for local services to get back into financial balance.
"I am determined that the West Midlands NHS, in return for its £6.5 billion investment, will meet national targets and achieve financial balance, whilst delivering better services in 2006/07."
