Specialist care is the best

Doctor Harry Walmsley, a director at the Trust which runs the DGH, also came out in support of specialisation and said he would much rather travel 20 miles to be treated by an expert in their field rather than a consultant who would only occasionally perform any given operation.

Mr James said, "A recent report has indicated 500 extra lives could be saved each year if people travelled further to a specialist centre. Patients would be safer in an ambulance that would stabilise them.

"I am yet to be persuaded by the statistics that it is better to provide 24-hour care in each local hospital."

Similarly, Dr Walmsley gave his full support to idea of specialisation of services and said it was no longer realistic or desirable to expect every surgical service to be available on people's doorsteps.

He said, "When I first arrived here, if you had something as serious as an aortic aneurysm, whichever consultant surgeon was on call did the surgery.

"Now we have two specialist surgeons in the Trust who will perform this surgery, and personally I would rather have an expert doing the surgery.

"I would want to be in a centre of excellence '“ not in the hands of part-time jobbing people.

"That's not to denigrate the brilliant job these people have done, but these days so much more of our surgery is specialised.

"The surgeons will be doing these operations all of the time, and if that means travelling 20 miles then that is what I would I do.

"I agree the services we are used to having won't be able to continue, and that is because of increasing specialisation."

Dr Walmsley also said staffing issues would play a big part in the Trust's decisions about what services could be offered at each hospital.

These issues include the European Working Time Directive, which will limit a doctor's working week to 48 hours, and the Modernising Medical Careers programme, which will change the way junior doctors are trained.

Critics have said this could result in less experienced and fewer junior doctors.