NHS managers have revealed that the boost in funding next year will take the county's total budget to �645m.

The Royal Cornwall Hospital Trust's debt could reach �45m by the financial year's end, but NHS South West said it hoped it would be paid in five years.

Patient representatives are still concerned services may be threatened, but hospitals trust boss John Watkinson has ruled out big cuts and job losses.

Offsetting debt

The chairman of NHS South West, Sir Michael Pitt, said the extra money would bring huge benefits for patients and for the public.

He said: "That is a huge amount of additional money and we think it can be well invested in the county and can be used to offset the hospital trust's debt.

"The message to the county is that health is improving, and that there is a huge strategic plan for the county to be announced at the end of this month."

But Mary Figg, chairwoman of the Royal Cornwall Hospital's Trust Patient and Public Involvement Forum, said hard decisions would still need to be made.

She said: "I think that debt has begun to impact upon the service at the hospitals.

"We must protect the services and support the staff, or else they will be outsourced."

However, on Thursday Royal Cornwall Hospital Trust chief executive John Watkinson ruled out big cuts, widespread job losses and hospital closures to balance the books.

He said more efficient and effective use of trust facilities would maintain and develop the services provided by the Royal Cornwall Hospital, St Michael's Hospital in Hayle and the West Cornwall Hospital in Penzance.