“I am writing to you with regard to the NHS Sustainability and Transformation Plan (STP) which was due to be submitted to NHS England.

“Sustainability”, as I am sure you know, means a plan to eradicate the financial deficit in the short-term. “Transformation” means plans to provide a cheaper health service in the longer term. This means drastic cuts driven, not by a desire for health care improvement, but simply in order to balance the books.

Prior to 2012 there was no deficit. The current deficit has been caused by a deliberate political choice to under-fund the National Health Service.

Britain’s spending on its health service is falling by international standards and, by 2020, will be £43 billion less each year than the average spent by its European neighbours, according to research by the independent King’s Fund.

Devon’s plan is already in the public domain and includes the loss of 400 acute beds, the loss of 190 community beds, and an 11% cut in the nursing workforce. “Consolidation of services” means that North Devon District Hospital will lose maternity neonatal and paediatric services and possibly acute stroke services.

The pressure group Save Our Hospital Services (SOHS) is mounting public opposition in North Devon and has a good Facebook page and website. Clearly this is of great interest to us in East Cornwall because 20% of Cornwall’s citizens access their secondary care from Devon.

Derriford Hospital is already struggling to cope with the workload and is frequently on “red alert” with bed shortages. It must now absorb much of North Devon District Hospital’s workload.

In Cornwall the deficit is £140million for 2016/17 and will be £277million by 2020/2021.

The draft outline Sustainability and Transformation Plan for Cornwall gives little detail as yet but the main thrust is out-of-hospital care and we can expect this means closing beds. More patients are to be looked after in the community but interestingly, according to their own document, 30% of GPs in Cornwall are planning to retire in the next three years.

Nationally there has been a 28% reduction in district nurses since 2009 and local authority spending has fallen by 17%, while the number of people over 85 has risen by 9%.

In the light of this the aspiration to keep people out of hospital seems somewhat optimistic and much of the burden is likely to fall on unpaid carers. The plans envisage “a few urgent care centres… in place of a multitude of unsustainable minor injury units”. There is likely to be a sell-off of estates and a reduction of the workforce.

Councils have been asked not to publish these Sustainability and Transformation Plans (STPs) and they are due to be signed off on December 23, just two days before Christmas – an excellent time to bury bad news.

The result of this secrecy and timing is likely to be that there will be insufficient public consultation and no time for the public to organise against the cuts.

The geographically based “footprints” are an undemocratic de facto extra-legislative reorganisation which has not been subject to the scrutiny of Parliament, as all previous health service reorganisations have.

I am asking for your help in ensuring the Sustainability and Transformation Plan (STP) plans are published as soon as possible and that Cornwall Council’s health oversight and scrutiny committee do not pass the plan without extensive and meaningful public consultation.”

Dr Jan Macfarlane is a retired GP from East Cornwall