Scores of hospital departments such as maternity units and cancer clinics will be closed or merged across the country under plans for a radical shake-up of the NHS.
Labour ministers are preparing for a summer of protest as residents campaign against proposals that could mean local hospitals losing specialist services to large regional centres.
In an attempt to head off the reaction that could mar the 60th anniversary of the NHS in July, Lord Darzi, the health minister, has pledged that patients would be involved in decisions and hospital units would not close before new ones opened.
Lord Darzi, a surgeon, said specialist services would be moved into larger regional centres only where there was evidence to prove that doing this would provide better care.
But critics argue that this will mean patients having to travel much farther for an operation or an appointment.
The plans, which appear to have been held back until after last week’s local elections, will be released over the next four weeks by the nine Strategic Health Authorities in England.
They include setting a local target of reducing the four-hour wait in A&E; to two hours, setting up dedicated trauma centres and better co-ordination of out of hours services.
However, in many cases, the changes – which result from Lord Darzi’s continuing review of the NHS – will lead to services provided by cottage and district hospitals being moved out of the area.
He acknowledged that the plans would bring protest and said that in the past, officials were poor at communicating the reasons behind such changes.
Lord Darzi said that where care did not need to be provided in hospitals it could be moved into health centres, GP clinics and cottage hospitals closer to patient’s homes.
He is convinced that when doctors have led previous changes and explained that they were not being carried out for financial reasons but in the interests of better care, the local community eventually agreed to the plans.
In an interview with The Telegraph, Lord Darzi said the plans were not about closing local hospitals or shutting down good services but were aimed at improving standards of NHS care.
“We need to be much more ambitious,” he said. “We spend £110 billion a year on the NHS and we have to challenge ourselves in raising the clinical bar.”
He said the challenges of an ageing population and increasing numbers of patients with long-term conditions such as asthma, diabetes and cancer meant changes were needed.
But campaigners and opposition MPs expressed concern. Residents and patients in Ipswich are already furious at proposals to move the head and neck cancer service from the local hospital to Norwich.
“Patients want to be treated in their local hospital safely,” Katherine Murphy, of the Patients Association, said.
“To be admitted to a hospital 60 miles away from your home is not convenient. It is all very well having specialist centres around the country but it is not want the public want.”
Andrew Lansley, the shadow health secretary, said: “We value our local NHS services and don’t want to lose them. Labour seem completely out of touch with that feeling.
“The hints Lord Darzi has given today about his plans for the NHS sound extremely ominous.
“We already know about the huge upheaval and loss of local services there’s likely to be in London; now we learn that something similar will happen in every single region.
“Lord Darzi is tripping over himself to say there isn’t another big, top-down reorganisation of the NHS coming; unfortunately he has only heightened suspicion that that’s exactly what this is.”
Councillors will be able to raise objections with Alan Johnson, the Health Secretary. He can ask for an independent panel of experts for advice and where this has happened in the past, the verdict has usually been accepted.
Dr Hamish Meldrum, the chairman of the British Medical Association, said: “These principles are all positive – in fact they’re impossible to disagree with. The problem is that the public and health-care staff have yet to see much evidence of them being delivered.”
Health Direct asks what became of joined up thinking and a green focus? By closing local health facilities- patients, relatives and friends will have to fork out more on brown’s transport stealth taxes to travel further to visit the victims.