Why is Heatherwood and Wexham Park Hospitals Trust in debt?

Heatherwood Hospital was founded in 1922

Heatherwood and Wexham Park Hospitals NHS Foundation Trust is £10m in debt and needed an £18m loan from the government last year.

This week it closed its Heatherwood birth unit, due to staff being on long term sick and maternity leave, and it is not known when it will reopen.

It has been confirmed the trust is looking at closing Heatherwood Hospital as an option for the future.

So why is the trust experiencing these difficulties?

Some say the PCT has not funded the hospital adequately, while others blame population change and patient choice.

BBC Radio Berkshire spoke to a hospital worker at Heatherwood Hospital's birthing unit, the head of NHS Berkshire West PCT, the MP for Windsor and a Bracknell GP to find out their views.

Charles Waddicor, Chief Executive of NHS Berkshire PCT

"The government gives money to the PCT to fund NHS services for patients in Berkshire.

"The PCT then pays GPs and hospitals for the care they give individual patients.

"For planned care, such as a hip or knee replacement, patients can choose where they go for that care, which hospital they go to, after a discussion with their GP.

"It's the patients in the Bracknell and Windsor and Maidenhead area making that decision, and patients are choosing to go to other hospitals than Heatherwood and Wexham, such as Royal Berkshire Hospital and Frimley Park.

"If you think of Heatherwood, it's in Ascot, which is a small market town, but actually the bulk of the population is in Slough or Bracknell.

"When that hospital was built in the 1930s, the populations were very different.

"The vast majority of patients in east Berkshire continue to go to Wexham for their treatment.

"If hospitals are going to stay open they need to respond to the wishes and requirements of patients and GPs."

Adam Afriyie, MP for Windsor

"I'm not a paranoid conspiracy theorist by nature, but there does seem to be a lot of pressure from the PCT for services to be re-allocated across the whole of Berkshire.

"The PCT and local GPs have decided to send patients to other hospitals. Every time that happens, the hospital misses out on money. That worries me.

"There aren't any clear proposals for people to consult on or give their view on but we know there is a threat to Heatherwood.

"Heatherwood and Wexham Trust don't want to close this hospital.

"They've done a great job in turning around the trust over the last two years. It was literally bankrupt two years ago and now we're in a position where it's sustainable.

"What I would say to the chairman of the PCT is... 'make sure you've found your cost savings and efficiencies in the PCT before you make cuts in the services in the Windsor area'."

Heatherwood birth unit worker (anonymous)

"I do accept it's becoming unsafe. If you have people on continual long term sick leave or maternity leave, you can't replace them.

"You do have people working 24 hours at a time, so it does become unsafe. It's only a temporary closure because of this staff shortages.

"I don't think they did everything they could to cover the staff. We've never had any agency staff up at Ascot.

"The PCT's finances have gone to Frimley Park and Royal Berkshire Hospital, and yet we've got a huge growing community in Bracknell that is expanding.

"The PCT is not in support of this unit and they've never been in support of this unit. They're always surprised to know we are still going."

Bracknell GP Jeremy Platt

"Heatherwood and Wexham Park Hospital Trust says it is struggling because fewer patients are going there and more patients are going to other secondary care trusts.

"While this may be true there's no concerted effort on the part of GPs or PCT to divert patients away from Heatherwood and Wexham Park hospital. Patients are doing that themselves.

"Patients will say, 'I don't want to go to Wexham, I want to go to Frimley or Royal Berkshire Hospital'.

"It could even be because of things you wouldn't think are important to patients, like car parking. Whether that's the root cause of why they're in a financial mess, I couldn't say.

"There's certainly services at Heatherwood that patients use and are very satisfied with, and if that continues to happen that will be a very good thing."