"There are massive cuts taking place across our NHS in general - either covert cuts like "natural wastage", early retirement and not replacing workers that have decided to leave/retire, or overt cuts like redundancies and so-called 'back office cuts' " according to a health worker in Somerset.

The situation within the Foundation NHS Trust that I am employed within is slightly unique (at the moment) as they are in a position of actually employing people and finding themselves within a sound financial position. The Foundation tell us that we are a "not-for-profit" organisation and during the previous tax year the organisation made a surplus profit of around £450,000 - despite closing down units and reducing inpatient beds, which, of course, they are not so quick to highlight.  
 
Overall, the Somerset Partnership Foundation NHS Trust - primarily a mental health service - shows that no cuts have taken place to date and figures will be released once the takeover of the PCTs has been finalised sometime this year.  Once this has happened, then local issues around health and privatisation proposals within this predominantly Tory county will come to the fore. The chief executive (as is the whole board) seem to be completely behind Lansley's Bill and I would imagine that despite the rhetoric of "putting patients first" the real driving force is profits for the speculators, especially during future merges and takeovers.
 
Amalgamation of community services with in-patient services and GP commissioning is going to bring up a number of conflict of interests within the area. For example, community nurses are paid a different rate to mental health nurses within inpatient settings, therefore contracts of employment may have to be negotiated. 
 
Most of the employees that I speak to know that PFI and fragmentation of services (either selling off NHS buildings or reducing beds, etc) is morally wrong but at the same time many are fearful to speak out.  Usually, on the grounds of ignoring the political issues and hoping that their own individual jobs will not be on the line, so to speak or they feel powerless in relation to policies being forced through without consultation or agreement within the workforce.