Health Secretary Patricia Hewitt has refused to ease the financial crisis facing the NHS in Sussex.

On a visit to Brighton on Friday, Mrs Hewitt said there were no plans to wipe the slate clean for debt-ridden hospital trusts.

On the same day, The Argus learned that between 30 and 50 per cent of medical secretaries working in Brighton may lose their jobs because their work may be contracted out to companies abroad to save money.

Brighton and Sussex University Hospitals NHS Trust, which runs the Royal Sussex County Hospital in Brighton and the Princess Royal Hospital in Haywards Heath among others, ended last year about £13 million in the red. When previous debts are taken into account the figure rises to nearer £23 million.

It has spent more than £500,000 on a team of financial consultants to help get it back on track and one of the ways to save money is to cut back on 325 posts.

Mick Molloy, the GMB union's convener at the hospital, was angered by the news about the secretaries.

He said: "When the issue of posts being cut first emerged the Trust promised it would do everything it could to avoid redundancies and the jobs would go through natural wastage.

"Now we find that medical secretaries are getting information that their job is going to be downsized. That doesn't sound like natural wastage to me.

"Morale is very low at the moment."

The Argus revealed last October that a pilot scheme had been launched at the Trust, in which the notes from cardiac patient were transferred more than 6,000 miles to South Africa to be typed up.

The Trust employed Global Secretarial in Cape Town on a three month contract which was expected to save about £150,000 a year. One member of staff, who did not want to be named, said: "We have been told that this scheme may be extended and all records across the hospital will be dealt with in this way.

"That means the whole personal touch is lost. Many of us have mortgages and bills to pay. We can't afford to lose our jobs."

Mrs Hewitt's visit coincided with a meeting in Burgess Hill where the South-East Coast Strategic Health Authority (SHA) was outlining its review of all hospital services across Sussex as part of plans to reduce debts of more than £100 million.

The changes are expected to lead to the downgrading of either Worthing Hospital or St Richard's Hospital in Chichester, which would mean longer journeys for patients attending accident and emergency, children's and maternity services.

Services at Eastbourne District General Hospital and the Conquest Hospital in St Leonards are also at risk.

Thousands of people have signed petitions in various campaigns around the county and health bosses have been warned they "have the mother and father" of all battles ahead of them.

The SHA said no decisions had yet been made and a full consultation would be launched in the autumn.

Mrs Hewitt spent the morning at Mill View Hospital in Hove and the nearby Martlets Hospice before visiting the Royal Sussex in the afternoon.

She spoke to staff and patients at the A&E department before visiting the renal unit.

She was told how the new children's hospital is developing and was given a tour of the Barry building.

She then spoke to staff at a question and answer session for more than an hour.

After the meeting she said she could understand the concerns of patients about the future of services but said it was vital finances were brought under control.

She said: "There are no firm proposals at this stage regarding hospital changes in Sussex but it is clear something has to be done.

"The Trusts have gone on overspending over the years and it needs to be sorted out.

"There is no point playing the blame game, we just have to make sure that Trusts that have been struggling financially get back into a break even position as quickly as possible.

"There have been NHS organisations in the past that have had their debts written off but have then got themselves back in trouble again.

"I don't feel that is where the focus should be.

"The focus needs to be on getting them on a financial even keel so they can then concentrate on the future."

Mrs Hewitt said the Government did take notice of the needs of elderly people who need extra support and recognised there was a large population of older residents in the county.

She said that was why there was a move towards providing more services in the community so patients would find it easier to get access to services.

She said: "I understand there is uncertainty at the moment but this ongoing piece of work is aimed at providing a safe and sustainable service for everyone at a cost the NHS in Sussex can afford.

"We have been investing large amounts in the NHS and we need to ensure that each part of the organisations is doing its part and providing the best service possible."