Downgrading fear for London hospitals

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The proposal, from a group of senior doctors, nurses and midwives, is part of a huge NHS shakeup affecting one million people.

It would mean two centres would be downgraded out of University Hospital Lewisham, Bromley Hospitals, Queen Elizabeth Woolwich, and Queen Mary's Sidcup to offer more outpatient surgery and care for minor injuries.

Campaigners attacked the plans as a cost-cutting measure as the area's health service tries to overturn a £65million debt and improve standards-But those backing the plan say it will raise standards. Dr Roger Smith, medical director of Queen Mary's, said: "This issue coincided with a developing financial problem.

"We need to improve care but many departments simply aren't big enough. "If we remain as we are, we are not going to be able to provide the consultant cover that we need."

In a statement, the four medical directors of each hospital trust said they wanted to make sure that all specialist units see enough patients per year to achieve better results.

They said: "We have looked at the best way to provide hospital services for the whole population."