UNION officials want to know if the controversial private finance initiative contributed to a cash crisis at a North-East superhospital.
South Tees Hospitals NHS Trust has been ordered by the district auditor to make cuts of £66m over three years to settle huge cumulative debts.
Apart from the initial loss of 161 jobs, there are fears for the future of Guisborough Maternity Hospital, which is subject to a review.
Liz Twist, head of health for Unison, which represents thousands of North-East health workers, says she will be pressing the South Tees trust to come clean about PFI.
"We will be asking the question how far has PFI contributed to the serious financial problems we are seeing at South Tees," said Ms Twist.
Unison has criticised the Government's policy of using the private sector to build and run new hospitals for the NHS, arguing that it usually proves more expensive.
The initial bid for the contract to modernise and expand the 1,000 bed James Cook University Hospital, in Middlesbrough, in the late 1990s was only £65m but, by the time the project had been completed, the cost had gone up to £165m.
"The trust is committed to paying a huge slice of their budget back to the private contractors every year," said Ms Twist.
Trust chief executive Simon Pleydell told The Northern Echo that there was "no simple answer" to the financial difficulties.
"We deliver a lot of specialist services here and the cost of those services have actually outstripped the income we have received. We have also expanded and that has not always been supported by an increase in our income."
But Alan Foster, financial director of the County Durham and Tees Valley Health Authority, said there had been "a lot of additional costs" associated with the PFI contract.
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