Shrewsbury and Telford Hospitals NHS Trust ran up a �10.1m deficit in 2004/05 an audit by KPMG has revealed. It comes on top of a �9m historic debt.

The trust said it was unexpected but a new ward, a new unit and �400,000 for cancer drugs had contributed to it.

The region's strategic health authority said it was shocked but has not decided whether it will make the trust pay back a �2m loan given to help it break even.

'Efficient trust'

The trust said the opening of an isolation ward at Telford's Princess Royal Hospital and of a clinical decisions unit at the Royal Shrewsbury Hospital, together with �400,000 for special drugs for cancer patients, had all contributed to the debt.

Andrew Prichard, acting chief executive said: "This has been a very challenging year for the trust, but the most effective care of patients has always been our top priority, regardless of whether we could guarantee additional funding from the primary care trusts.

"As a doctor I could not justify withholding treatment from patients with the most serious illnesses just to balance our books."

He said the trust is one of the eight most efficient in the country and has the lowest management costs in Shropshire and Staffordshire.

"If Shrewsbury and Telford were being paid at the national average for their work we would have been some �15m better off last year," he said.

"Obviously we will be having ongoing discussions with the primary care trusts who buy their services from us to set more realistic prices for this year, but I don't apologise for putting patients first."