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HEALTH care in Stroud is under threat as NHS bosses face making £9 million of cuts in the Cotswolds over the next six months.
Cotswold and Vale Primary Care Trust - which already has debts of £5 million - is forecast to overspend by a further £5.5 million this year.
As a result, services at Stroud Hospital are under scrutiny as health chiefs struggle to make savings.
Joanna Wynn, spokesman for the PCT, could not put an exact figure on the savings needed in Stroud.
But she said: "We have got a mixture of ongoing debt but we are also spending beyond out budget each year.
"We are concerned that we are going to have additional pressures on our budget because we are going to have to put more money into patient care.
"We will be looking at Stroud Hospital along with all our hospitals and providers to look at how they can work more effectively."
Local politicians have reacted with anger - and fear front line services are likely to suffer.
Chas Fellows, leader of Stroud District Council (Cons, Chalford), said: "I sincerely hope the chief executive and his senior directors look very seriously at the overheads of the PCT to see if they can improve efficiency before they think about cutting services.
"I have a very firm view that over the years the NHS has become a bureaucratic nightmare, and it's about time it stopped.
"The cuts need to start where they will have the least impact on the patient."
Stroud mayor and town council chairman Cllr Kevin Cranston said cuts were a short term solution.
"Cutting healthcare is not a good thing, it just stores up problems for the future and one wonders why we are having to cut healthcare in the fourth wealthiest country in the world," he said.
"Maybe it is because we are squandering money on invading countries we should not be invading.
"It is certainly not because medical needs have gone down or inefficiency in medical services.
"It is a cut for no good reason as far as I can see."
The crisis began three years ago when the almost bankrupt NHS Strategic Health Authority for Avon, Gloucestershire and Wiltshire was bailed out by the government.
It has been ordered to save £178 million before March 31 next year - and is still £25 million short of targets.
A community campaign is already underway in Tetbury, where Cotswold and Vale has cut funding for six of the 11 beds at the town's hospital.
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