A West Midlands hospital has agreed to radical cost-cutting measures including a loss of beds, wards and buildings, to make potential savings of #21 million a year.
Managers of Good Hope Hospital in Sutton Coldfield last night agreed to the proposals as it struggles with a "worst-case scenario" deficit of #47.5 million by the end of next month.
A report produced jointly with the Heart of England NHS Foundation Trust (HEFT), which runs Heart-lands and Solihull hospitals and has managed the 577-bed Good Hope facility since November, set out two suggested plans.
The first would involve Good Hope achieving foundation trust status as a "stand-alone" organisation and making savings of nearly #15.8 million.
The second envisages achieving foundation trust status, plus annual savings of #21.06 million, in partnership with another NHS organisation.
Yesterday board members voted unanimously in favour of the second option to safeguard its financial future. The bid for a partner may go to tender.
However, this option includes flattening disused office buildings and medical staff accommodation to make way for 200 new car parking spaces, which could generate #480,000 per year. There is also a proposal to raise a further #80,000 a year by charging disabled motorists for parking.
The Sheldon Unit - which houses opthalmology, oncology, neurological and stroke services, and an elderly care rehabilitation centre - will be closed along with the Education Centre. It is thought these services will be moved into the trust's #17 million treatment centre, which opened last September.
The partnership proposal will also mean the loss of at least 80 jobs and the creation of a new trust board, creating savings of #3.3 million a year.
A #500,000 temporary operating theatre, the Vanguard Theatre, which the trust opened in November 2004, would also be closed.
In the joint report Dr Mark Goldman, chief executive of both trusts, wrote: "This hospital, which serves the health needs of many local people, spends #1 million more per month than it earns.
"It is not solvent without the continuous, very substantial financial support from the Strategic Health Authority.
"For Good Hope to continue in its existing form, considerable investment would be required from the local PCTs, probably beyond their means and certainly outside their existing strategic intentions."
After yesterday's meeting, Graham Comfort, Good Hope's chairman, said "doing nothing" was not an option.
He said: "This is a huge challenge to implement all these changes in time for us to meet the 2008 deadline to achieve foundation trust status. We have no option but to reach that goal, so our next port of call is the SHA to establish with them how the services within Option 2 can be delivered.
"Our worst-case scenario is a total deficit of #47.5 million. That is what would happen if we do nothing, but we are doing something about this.
"On bed efficiency, we've got to get our length of stay down to an acceptable level which, if we can do, will be the equivalent of treating 100 fewer people. Our #500,000 investment in the Vanguard Theatre was needed at the time, it was only ever a temporary measure."