Seven NHS hospital trusts in the West Midlands have reported debts totalling nearly £21 million, say health bosses.
Royal Wolverhampton Hospitals deficit of £9.4 million accounts for nearly half of the shortfall, with Sandwell and West Birmingham NHS Trust responsible for a £6.2 million debt.
Good Hope, Walsall Hospitals, and Birmingham Children's Hospital trusts also reported overspends of between £1.2 million and £2 million.
Elizabeth Buggins, chairman of Birmingham and the Black Country Strategic Health Authority (SHA), asked how confident the board is that the trusts can achieve financial stability.
She said: "What confidence have we got that this position will be better and require less intervention during 2005/06?
"We need to be going towards a more robust position in the coming financial year."
Tom Taylor, the authority's deputy chief executive and director of delivery, said he was confident the trusts' finances would be brought to balance.
He said: "We will still have to manage and intervene but that's partly due to the ambitious targets we've set ourselves. If anything we could be victims of our own ambition.
"These deficits will not be wiped out overnight because that would affect services, and we're not going to do that."
Mr Taylor added: "We've agreed a recovery plan with Royal Wolverhampton Hospitals which will set the levels by which they can bring themselves back into balance.
"This isn't all about new money. We need them to look at how they can use existing funds more efficiently."
A recovery plan has also been set up for Sandwell and West Birmingham NHS Trust to follow. The SHA has set the trust a number of financial targets it must meet by the end of this month.
Three primary care trusts (PCTs) - Dudley South, North Birmingham and Solihull - also report debts of £2.4 million.
Solihull PCT has the biggest shortfall of £1.5 million. However their forecast year end position is much improved on earlier predictions, which identified a potential deficit of £4 million.