Hospital staff say hundreds of local jobs could be threatened by the outsourcing of secretarial work to foreign workers in India or the United States.

Fears that the Oxford Radcliffe Hospitals NHS Trust might transfer a hefty slice of clerical and administration work overseas has raised the spectre of a second wave of NHS redundancies in Oxfordshire.

In the West Country, hospital workers are threatening industrial action to stop redundancies after the Royal Cornwall Hospitals Trust said it had plans to send typing work abroad.

Now health staff in Oxfordshire believe that the ORH Trust, faced with making savings of £33m, is considering a similar course. And the health workers union Unison this week called for a campaign to resist any outsourcing moves.

Outsourcing has become a common practice for banks and computer, electrical and telecommunications firms.

Unison believes up to 500 health jobs at the John Radcliffe, Churchill, Radcliffe Infirmary and Horton in Banbury could be affected, with medical secretaries, personal assistants and audio typists seen as vulnerable.

In a message to its members, Unison's Oxfordshire health branch warns: "Members should be in no doubt the trust is under great pressure from Health Secretary Patricia Hewitt to make large savings. The trust has already said that the admin and clerical staff budget is overspent by over a million pounds.

"The trust is right to be concerned how its staff could react. Members are already coming forward to say if outsourcing takes place they want to take action just like their counterparts at the Royal Cornwall Hospital."

Alarm bells began to ring when secretarial staff were asked to fill in detailed questionnaires about all aspects of their work as part of a extensive administration and clerical review.

With rumours circulating that an outsourcing deal with the US-owned company Dictate IT was being lined up, Unison officials called on the trust to "come clean."

A letter sent to staff by the trust says no decision has been made about outsourcing. But it makes clear that no options are being ruled out.

Philomena Tennant, the project manager head of the Trust's administration and clerical review, said the questionnaires were for "a trust-wide review of business process."

She tells staff: "I understand that there is some anxiety that the Trust has already committed to outsourcing key secretarial functions. I can assure you that no such decision has been made, although the trust is, as you would expect, considering all options for the provision of administrative support.

"I anticipate that a proposal will be made to the trust's executive board in the coming months and will let you have further details in due course."

The ORHt is already well into the process of shedding 600 jobs across its hospitals, along with 160 beds. Chief executive Trevor Campbell Davis said it now looked like "no more than 60 staff" would have to be made redundant under the cost cutting plan.