A BLEAK winter loomed large in the health service last night after hundreds of people were warned that even more cuts could be required to slash a crippling £40million debt.

A BLEAK winter loomed large in the health service last night after hundreds of people were warned that even more cuts could be required to slash a crippling £40million debt.

More than 500 worried members of the public packed the Elizabeth Orwell Hotel, Felixstowe, for the latest update on the budget crisis facing the East Suffolk Primary Care Trusts (PCT) – and they were told some health services could be suspended over the winter.

Carole Taylor-Brown, chief executive of the trusts, said: ''We have to balance our books, we have no choice in that matter. It may be necessary for the temporary cessation of services over the next few months.''

She admitted she could not give a cast-iron guarantee that the Felixstowe General Hospital would continue to function in the long-term.

The PCT wants to spend £800,000 upgrading the hospital to replace the Bartlet Hospital and Mrs Taylor-Brown said: ''There is no certainty that things will remain as they are for ad infinitum. We are committed to keeping the FGH for as long as it is viable for us to do so.''

Julian Herbert, finance director, warned there was no guarantee the estimated £3m proceeds of the sale of the Bartlet Hospital would benefit the health service in east Suffolk.

He said: ''The Strategic Health Authority have the option to take back disposals over £1m and pool some of that capital funding for use in the Norfolk, Suffolk and Cambridge area.

''Our opportunity is to put forward a case for local investment and we want to put £800,000 into the General to bring it up to 21st Century standards. Informal discussions with the SHA have been very favourable over that. There is this small level of risk of pooling the funds in the Norfolk, Suffolk and Cambridge area.''

One aim of modernising the health service is to reduce the time in hospital and take patients back into the community quickly.

Mark Halliday, chief executive of the Suffolk Mental Health Partnership Trust, said: ''We want to support even more people in their own home, we know that they get better quicker in their own home and we know from experience and from what people tell us that the majority of people with mental health and learning disabilities are happiest at home and recover faster at home.''

John Such, an assistant director with the county council's social care and the PCT, said: ''A key thing is to stop people going into an acute hospital who do not need those services. Some people's homes may need adaptations but a lot of people can live at home with some minor equipment.'' He added the county council was still trying to recruit more carers.

But many members of the audience claimed that they preferred to be treated at hospital and John Gummer, Suffolk Coastal MP, who was chairing the meeting, told the health officials: ''Many of my constituents do not have a home that is suitable for them to go directly back to. Nobody believes you that you will have the services in place for them to go into their own homes and people get cross because they do not believe it."