FEARS Ealing Hospital may be scaled down were raised again this week after the government spending watchdog said it cannot continue in its current form.

It is among one in five hospital trusts nationwide struggling to survive in the tough economic climate.

Talks are already underway to merge the trust with North West London Hospitals Trust, which runs Central Middlesex, Northwick Park and St Mark's hospitals.

And the report by the National Audit Office released yesterday means this is now almost certain to happen. Otherwise they will not meet the government's deadline to become a foundation trust, giving them more independence from the Department of Health, by 2014.

The new merged trust would be too much of a drain on the public purse for all services at the hospitals to run as they currently do and both politicians and patients fear Ealing may suffer as a result.

Ealing Southall MP Virendra Sharma said: "I've spoken to the Prime Minister in the past, he gave the indication that Ealing Hospital was not under threat when I raised a question in Parliament last year.

"He added that it would be the local community that would decide, professionals and political people would be consulted before a final decision.

"However this report shows that promise may be hollow, confirming our worst fears that Ealing Hospital is under a severe threat, which we will fight."

Patient group member Dilmohan Singh Bhasin, said people would struggle to get to other hospitals if their needs were no longer met at Ealing.

He said: "Travelling is a big issue. For instance Northwick Park Hospital is very difficult to get to on public transport from most parts of Ealing."

An Ealing Hospital Trust spokesman said no decision on a merger had been taken and more will be known when a business case goes to both boards next month. But pointed out a merger would bring benefits, with clinical teams sharing expertise.

He added: "It has been clear for some time that many hospitals are not financially viable in their current form given there's a national drive to move care outside hospitals and closer to people’s homes resulting in a shift of funding away from acute hospitals to community-based services. This means the proportion spent on hospitals will reduce."

He added the better community care would better prevent hospital admissions.