Hospital hiatus

Ostensibly, it needs to save 55m in the next two years because the trust is transferring services to newly-opened hospitals in Pontefract and Wakefield, in addition to its other centre in Dewsbury, which it must run more cost-effectively.

It also reflects a national NHS requirement for major efficiency savings. Yet the trust, which has been beset by financial difficulties, still predicts that it will be in the red after this shake-up.

The coalition Government's health programme has been far more radical than many had expected, given the assurances offered before the election, but it has raised many more questions than it has answered.

Plans to effectively axe strategic health authorities and the bulk of functions of primary care trusts will sweep away vast tiers of bureaucracy – although it remains likely they will be replicated elsewhere in another form. Other savings will have to be made if the NHS is going to stand still.

As such, the Government's pledge to protect all frontline services looks both foolhardy and hollow. It is difficult to see how this pretence can be retained when hospitals, and doctor's surgeries, come to terms with their budgets.

The coalition's challenge, given this backdrop, is to reassure patients and the medical profession that the NHS is safe in its hands – and that efficiency savings can be achieved in a responsible way which does not result in waiting times spiralling out of control.