AT least 220 hospital jobs in Lancashire will be at risk under controversial plans to use a private firm to treat NHS patients, a senior manager has warned.

A leaked document states up to 360 posts could go at Chorley and South Ribble District General Hospital and Royal Preston Hospital.

Private firm Netcare is to carry out diagnostic and minor operations normally carried out by hospitals to bring down waiting times from June.

But doctors in East Lancashire have warned this will put existing NHS hospital services at risk.

Now a memo from a top boss at Lancashire Teaching Hospitals NHS Foundation Trust, which manages the Preston and Chorley hospitals, raises the same fears.

The Preston hospital provides specialist services not available in East Lancashire such as brain surgery, some cancer care and plastic surgery.

Any patient in East Lancashire can also choose to go to the hospitals for all types of care.

A memo to Tony Curtis, chief executive of Lancashire Teaching Hospitals NHS Foundation Trust states: "Unfortunately job losses across the organisation, as experienced within other trusts, cannot be ruled out."

The memo, from the trust's director of operations, Colin Scales, puts forward two scenarios:

"Using our average cost per employee, at least 220 posts would be at risk".

"With a loss 5.4 per cent of turnover, up to 360 posts would be at risk (5.4 per cent of posts)".

The news comes as NHS bosses prepare to defend the plans at the first of a series of public meetings at Clitheroe Health Centre tonight.

They say the extra work needs to be done by Netcare to ensure that by the end of 2008 no patient is waiting longer than 18 weeks.

But the memo states the trust "have "demonstrated our ability to deliver the maximum 18-week referral to treatment standard by the end of this calendar year".

This echoes the views of top doctors at East Lancashire Hospitals NHS Trust.

The Lancashire Telegraph revealed on Monday that the four most senior doctors at the trust had written to GPs raising fears over the plan.

They said it threatened three key specialties in which they were on course to hit the 18 week waiting time by the summer.

The memo from the teaching trust states: "The activity to be delivered by the independent sector would not represent additionality and would therefore represent a very real threat to our operating income to the tune of £15.8 million, i.e. approximately 5.4 per cent of turnover".

Of this £15.8 million, salary costs would be £10.4 million the memo states, therefore putting jobs at risk.

Tony Curtis, Chief Executive, Lancashire Teaching Hospitals NHS Foundation Trust, said: "The impact on the local hospitals is difficult to predict with absolute accuracy, but with all GP referrals from six specialties being referred to the Clinical Assessment, Treatment and Support (CATS) services it is very unlikely that the hospitals at Chorley and Preston will not be affected and we have estimated that we could lose as much as £16 million of income.

"With the loss of income and local hospitals left to provide the costly complex care, existing services will deteriorate and there is a possible scenario that services will close or be significantly reduced.

"We will do everything possible to minimise redundancies but the stark reality is that at present, we believe that we have sufficient demand for our services to ensure that we can maintain services for 2007. Thereafter if CATS is implemented then we will need to reduce jobs."

The Netcare centres will be in East Lancashire at Beardwood Hospital, Preston New Road, Blackburn, and St Peter's Health Centre, Church Street, Burnley.

The other site will be at Preston Healthport, Fulwood.

The meeting will take place at Clitheroe Health Centre, Railway View Avenue from 7pm to 9pm.