NINETEEN health services in South Worcestershire including the region's only overnight cancer ward, district nurses, out-of-hours GPs and sexual health clinics are to be axed to help bale out the NHS's mounting national debt.

The services were chosen by South Worcestershire Primary Care Trust Board members during a heated four-hour debate yesterday morning.

The decision has left elderly patients and cancer nurses distraught.

The cuts, which will save the Trust £1.4m, are urgently needed to help plug a £13m gap in the trust's funding.

The shortfall was created by the Government to help pay off the national NHS debt.

But even as the cuts were being decided, Health Secretary Patricia Hewitt was revealing that the NHS deficit has more than doubled in the last year to £512m.

The trust had hoped to implement the cuts immediately, but yesterday afternoon, Worcestershire County Council's health overview and scrutiny committee failed to decide if they must first go out to a three-month public consultation.

They delayed their decision until June 16, leaving staff and patients with an agonising wait.

If the proposals are implemented, cancer patients will lose the five-bed Macmillan Unit at Evesham Community Hospital.

Macmillan Unit ward sister Tess Barley said the decision would see cancer patients languishing in inappropriate care settings.

"The new 15-bed St Richard's Hospice is being built in Worcester but this was meant to be complementary to Evesham, not instead of," she said.

"And who knows what the 11 staff on the Macmillan Unit are going to do. One thing's for sure, we won't be going anywhere as a team and it's the team that makes the difference."

Ex-Evesham Mayor Coun Francis Smith, who led a passionate campaign to save Evesham Hospital when it was under threat of cuts last year, said she was dismayed by the decisions which will also see the day rehabilitation unit shut and the Bredon rehabilitation ward close until April 2007.

"The decision will further cement in the minds of Evesham people that the PCT is chipping away at the services of their hospital."

Services for elderly people - including the podiatry service and home visit service - have also been affected.

Brian Hunt, of Worcestershire Pensioner's Action Group, said: "They want the elderly to be mobile but how can they be if they can't walk?" he said.

"Also, they want more elderly people to be cared for at home yet they are cutting home visits.

"They see older people as a soft target."

The Trust's Chairman David Barlow agreed the proposals were unpalatable and nobody was happy about them but said that they had to go forward.

Acting chief executive of the Trust, Paul Bates, said money had to be saved but admitted that he had not received any letters of support since the proposals were put forward last month.

"I have communicated with hundreds of people including the public, health groups and MPs and there is opposition from every corner," he said.

Even with the measures and savings made in other areas, the trust is still looking at a £5.9m shortfall.

And Alex Stewart-Cleary, of South Worcestershire Patient and Public Involvement Forum, said the trust would have to be held accountable if there were any lapses in patient care due to the service cuts.

"I know of one PPIF elsewhere that is taking their local Trust to court because of this," he said.

There was a reprieve for Pershore Hospital which it was agreed would be kept open until the new one opens in November 2007.

The cuts and what they will save in 2006/07

· Closure of Bredon Ward at Evesham Community Hospital on a temporary basis to re-open in April 2007 - £201,500

· Closure of day rehabilitation unit at Evesham - £53,000

· Closure of palliative care beds at Evesham - £136,000

· Review bed payment for GPs providing medical cover at Community Hospitals - £30,000

· Discontinue payments for GPs attending hospital committees for Evesham Community and Malvern Hospital - £12,000

· Reduce podiatry service - £95,000

· Reduce sexual health services - £124,000

· Review management structure within provider services - £30,000

· Reduce health visiting service for the elderly - £56,000

· Discontinue nursing and therapy advisory group funding -£15,000

· Reduce physiotherapy service - £176,000

· Reduce occupational therapy service - £114,000

· Reduce palliative care education funding - £9,500

· Reduce GP Out of Hours -£157,000

· Reduce health visiting service - £84,000

· Withdraw funding from ethnic minority resource centre - £12,000

· Reduce adult speech and language therapy - £32,000

· Reduce school nursing service - £60,500