Medical secretaries have warned proposals to type up doctors' notes abroad could put lives at risk.

Brighton and Sussex University Hospitals NHS Trust is consulting staff on proposals to move its transcription services to South Africa and India.

The trust says it would save hundreds of thousands of pounds a year but the move could result in 65 jobs being lost at the Royal Sussex County Hospital in Brighton and the Princess Royal in Haywards Heath.

The move would mean a ratio of one secretary to three consultants.

A pilot scheme in the Royal Sussex's cardiac department last October involved consultants dictating letters and notes, with the details then sent to a company called Global Secretarial in Cape Town where they would be typed up and sent back.

Managers say a move to South Africa will lead to an annual saving of £15,673 per secretary while a similar service in India would save £6,258 per secretary.

In a letter to The Argus a medical secretary wrote: "The accuracy levels of Global Secretarial are reported as 95 per cent. This equates to an average of ten mistakes per new patient.

"This is very worrying indeed compared to an accuracy rate of at least 99.5 per cent from the trust's own secretaries."

The secretary said that by typing all clinic correspondence they were in a very strong position when a patient or GP rang up for a result or query.

The letter said: "We may have just typed the letter and can instantly give them the information they need.

"We know their medical history, we know what care the consultant has planned for them and how their case needs to be handled. By having our typing outsourced we will gradually lose the knowledge of each patient and how best to help them if they ring the department."

The letter said if consultants had to spend longer checking their letters and dealing with phone calls because the only secretary available was on leave or off sick they would have to see fewer patients.

The letter said: "I think the public should be made aware of the risks to their health care. It is about time the trust thought of the patient and not saving money."

A trust spokeswoman said: "While cost is not the main reason behind outsourcing this work there will be savings for the trust if it goes ahead with this option."

The consultation is due to end on September 13.