Jan. 18--IF ANYONE IS searching for some sign, any sign of consistency in this upside-down, underwater economy, then maybe there's some to be found in the annual list of Berks County's top employers.

Yes, some of these employers cut jobs last year. Others added to their employment rolls. Yet there was markedly little change in the components of the list.

But who knows what this year may bring?

One troubling omen has materialized in Manpower Inc.'s employment outlook survey for the fi rst quarter.

The Reading area was in a sixth-place tie for the weakest employment outlook in the nation, with a net outlook of minus 6 percent. That is to say, 16 percent of employers surveyed in Berks County planned to reduce their work force, while only 10 percent planned to hire. Most of the remainder expected to maintain levels.

But Gretchen Strouphar, branch manager of Manpower's Spring Township office, downplayed the gloominess of the report.

"One of positive things we're taking from it is, we are seeing some of our customers very, very active," Strouphar said. "People are just proceeding with caution. A lot of ... what we see is a holding pattern."

Ellen T. Horan, president and chief executive of the Greater Reading Chamber of Commerce & Industry, agreed, saying that employers are being cautious and hunkering down.

She hesitated to call an end to the recession -- "I keep hearing about the magical third quarter, but I haven't heard any strong cases for why" -- but said hiring may come around.

"I think that ... companies are running though their inventory, but you can only be so cautious so long," Horan said. "You can only hold out so long from purchasing or from hiring."

Once again the area's top employer, Reading Hospital added a remarkable number of jobs, almost 500, in 2008, which its president, Scott R. Wolfe, said was mostly attributable to the growth of its medical group, a network of formerly private medical practices. But Wolfe said he expects its employment trend of year-over-year gains to plateau over the next year and a half.

That is in large part due to the economy: As more individuals find themselves without affordable health care, demand for services will decrease.

"The less volume comes in here, the less of a revenue stream is available for costs already sunk in staff needed to run an operation 24/7," Wolfe said.

Ultimately, though, demand is expected to increase because of patients deferring care, which will lead to pentup illnesses and patients more urgently seeking care at later stages than they otherwise would have, he said.