Doctors say the cash crisis means waiting lists will grow

Plans for new hospitals and other medical buildings are being reviewed in order to prevent financial meltdown by the end of the decade.

They include the �420m private finance initiative (PFI) scheme to rebuild Manchester Royal Infirmary.

About 40 PFIs - such as those to build new wards at hospitals in Oldham and Bury at a cost of �500,000 each - are also threatened.

But the Greater Manchester Strategic Health Authority (SHA) said these schemes were only ever "aspirational" and it would now need to choose which projects to go ahead with.

NHS Cash Shortfall Accountants predict a �732m deficit by 2010 �420m plans to rebuild Manchester Royal Infirmary could be scrapped About 40 PFI projects are threatened Plans to build a new children's hospital WILL go ahead

The warnings are included in a report compiled by Grant Thornton accountants on behalf of the SHA.

It said a �12m deficit was expected this year instead of a predicted �18m surplus to cover the running costs of new buildings.

The report adds that, over the next decade, instead of having a �370m surplus, the SHA will actually be in deficit by �732m.

It says that going ahead with all of the planned PFI schemes would be "unaffordable" and that "choices need to be made".

Only one PFI scheme - to replace the Pendlebury and Booth Hall children's hospitals with a new hospital - is guaranteed.

People get seen later, diagnosed later and referred later and for a life-threatening disease that's a disaster Frances Kelly, Unison

Doctors told BBC North West Tonight they believed the cash shortfall would mean longer waiting lists.

Frances Kelly, from the public service union, Unison, said patients could die because of the crisis.

She said: "They're going to raise questions as to whether they fund the radiotherapy machine at Christies Hospital in Manchester.

"If that isn't funded then waiting lists for cancer patients for radiotherapy go up.

"There are also less headline-grabbing schemes such as reconfiguration of services at [Salford's] Hope Hospital and Salford Community Clinics.

What we have to do now is choose between these schemes to ensure that we've got equitable investment across the whole of Greater Manchester Neil Goodwin, Chief Executive, Greater Manchester SHA

"If those clinics aren't accessible to people, people get seen later, diagnosed later and referred later and for a life-threatening disease that's a disaster."

But Neil Goodwin, chief executive of the SHA, said its budget would have doubled to more than �4bn by 2010, meaning there would be money to spend.

He said: "This is about choosing what we're going to invest in terms of additional hospital buildings and services.

"So this is a great opportunity for Greater Manchester.

"What you have in the report is a list of 40 schemes which have come from hospital trusts and primary care trusts.

"We've asked them what ideally you would like to have money for.