Tuesday evening - shock news about Accident and Emergency Units

Government plans to reduce accident and emergency services at local hospitals and concentrate them at specialist regional centres were backed on Tuesday by two leading doctors.

The support came as Prime Minister Tony Blair called on medical clinicians to become "ambassadors" for change and improvement of the NHS.

Blair told a conference of health professionals he believed "the best is yet to come" in the NHS while at the same time conceding the difficulties of pushing through radical changes.

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Opponents are alarmed at the plans, which may see local hospitals losing their full accident and emergency services and fear that patients may die before they reach a specialist unit further away.

The government says the reconfiguration of services is designed to improve patient care, but opponents say the changes are being driven by a desire to cut costs.

George Alberti, the Department of Health's national director for emergency access, said changes in medical technology, not financial pressure, were behind the reforms.

"Every service cannot be offered by every A&E department -- it never has been, and never can be -- so it makes sense to create networks of care with regional specialist centres to give people the best possible treatment to the sickest people," he said.

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Longer journeys by ambulance did not mean more people would die, as long as they were travelling in the care of a paramedic.

He said campaigns to shield A&E departments from change were misguided.

"We cannot have a position whereby patients are being denied access to life-saving treatment in a specialist centre or being admitted to hospital unnecessarily in a mistaken attempt to protect local services in an unchanged state."

Roger Boyle, the health department's national director for heart disease and stroke, said new specialised treatments could save many hundreds of lives.

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But the specialist 24-hour facilities required for swift treatment of stroke and heart attack also meant concentrating services at "centres of excellence" rather than spreading staff and skills over too many sites, Boyle said.

Opponents said there was a danger that accident and emergency centres could be closed before more specialist centres were up and running.

"The crucial thing is you have to retain locally services that will cope with the common emergencies," Richard Taylor, independent MP for Wyre Forest, told BBC Radio.