Leading article: A suitable case for treatment

The symbolism is striking. In 1948 the father of the National Health Service, Anuerin Bevan, officially opened Trafford General, the first of the new breed of publicly owned hospitals. Sixty years on, the same institution teeters on the edge of bankruptcy.

Trafford Healthcare Trust has been struggling with cash problems for several years now. It is facing a £7m deficit by the end of March 2009 unless it gets spending under control. And now it has been forced to borrow £3m from the Department of Health to pay staff wages.

The unions are blaming the crisis on the Government's attempts to run the health service as a business. On the contrary, it is because the trust in question has not been run like a business that it is in such trouble. The present difficulties are the consequence of years of mismanagement and inefficiency.

A "turnaround" plan drawn up by a new management team has been approved by the Strategic Health Authority. Some 200 jobs are scheduled to be lost to balance the books. Trafford General will also close two of its seven operating theatres and is to rent out three wards to other local hospitals to bring in more cash. All this is sensible. Providing that responsibilities such as infection control are not neglected, it is right that trusts take measures to balance their books. The Government has invested a huge amount in the health service since 2000. A depressing amount of this has been wasted. The days of inefficiency and profligacy on the part of NHS trusts must end.

In fact, Trafford Trust's financial problems are rather atypical of the present NHS. The health service as a whole is forecast to record a surplus in 2007-08, wiping out the budget deficit of the previous year that sparked a painful round of belt-tightening. Trafford was rather late in confronting its problems and now finds itself playing catch-up.

Yet this trust's plight is about more than financial mismanagement. It is also indicative of the changing shape of our health economy. One of the reasons Trafford General is under pressure is that patients are increasingly getting the care they need elsewhere, at smaller community hospitals or specialised treatment centres. The demand for large, traditional district hospitals is shrinking. The Government's internal market reforms are beginning to have an effect.

While this may be uncomfortable for the employees of Trafford General, or any hospital that finds itself under similar pressure, it is a process that promises to benefit the majority of patients in this country. For those who want a national healthcare system fit for the 21st century, it is something to be embraced, not resisted.