Up to half of all hospital accident and emergency departments face cuts or closure under plans to improve patient care, presenting Gordon Brown with a massive dilemma as he takes over as Prime Minister.
Ninety-two out of 204 A&E departments are under threat if guidance attributed to the Department of Health by NHS trusts is followed, the Conservatives claimed last night.
Some NHS organisations are already using the guidance, which calls for A&E departments to serve a minimum population of 450,000 patients, to justify closures in smaller catchment areas. The average A&E unit currently serves just under 250,000 people.
But the plans are proving hugely unpopular, even though they have been promoted as in the interests of patients and NHS staff.