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| Health boss hints at NHS overhaul | Health boss hints at NHS overhaul |
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| Hospitals could be stripped of services in the run up to the next general election, the new NHS chief says. | Hospitals could be stripped of services in the run up to the next general election, the new NHS chief says. |
| In his first interview since becoming NHS chief executive earlier this month, David Nicholson said there would be up to 60 reviews of hospitals in England. | In his first interview since becoming NHS chief executive earlier this month, David Nicholson said there would be up to 60 reviews of hospitals in England. |
| He said the changes could affect every region, and may lead emergency, maternity and paediatric care being centralised in fewer hospitals. | He said the changes could affect every region, and may lead emergency, maternity and paediatric care being centralised in fewer hospitals. |
| Mr Nicholson told The Guardian the NHS was facing some "tough decisions". | Mr Nicholson told The Guardian the NHS was facing some "tough decisions". |
| Undoubtedly there will be tough decisions to make over the next 12 months to reflect changing services David Nicholson, NHS chief executive | Undoubtedly there will be tough decisions to make over the next 12 months to reflect changing services David Nicholson, NHS chief executive |
| It comes after the BBC last month identified several trusts in London, Surrey, Sussex, Cornwall and Lancashire which were considering down-scaling or even closing major hospitals. | It comes after the BBC last month identified several trusts in London, Surrey, Sussex, Cornwall and Lancashire which were considering down-scaling or even closing major hospitals. |
| Mr Nicholson, who has worked in the NHS for 29 years, said some of the changes would be aimed at reducing the NHS deficit, which topped £500 million last year. | Mr Nicholson, who has worked in the NHS for 29 years, said some of the changes would be aimed at reducing the NHS deficit, which topped £500 million last year. |
| But he added it was also about improving services by providing the best care in fewer centres, although he acknowledged this would mean patients travelling further for treatment. | But he added it was also about improving services by providing the best care in fewer centres, although he acknowledged this would mean patients travelling further for treatment. |
| "Undoubtedly there will be tough decisions to make over the next 12 months to reflect changing services. | "Undoubtedly there will be tough decisions to make over the next 12 months to reflect changing services. |
| "Some will come sooner (than the general election). We are going to have to tackle the big patient issues. | "Some will come sooner (than the general election). We are going to have to tackle the big patient issues. |
| "I understand the politics of it, but this is about the way we deliver care which is predominantly closer to home." | "I understand the politics of it, but this is about the way we deliver care which is predominantly closer to home." |
| MPs are known to be touchy about the prospect centralising services even if they support the policy on a national level because of the public's affection for their local hospitals. | MPs are known to be touchy about the prospect centralising services even if they support the policy on a national level because of the public's affection for their local hospitals. |
| Labour lost a parliamentary seat at the 2001 election when Richard Taylor ran as an independent protesting about the removal of the A&E department at Kidderminster hospital. | Labour lost a parliamentary seat at the 2001 election when Richard Taylor ran as an independent protesting about the removal of the A&E department at Kidderminster hospital. |
| Liberal Democrat health spokesman Steve Webb said: "It is vital that any changes to the delivery of health services are driven by clinical priorities, not financial crises. | |
| "The public is entitled to be sceptical when big changes to local hospitals happen at a time of financial pressure but are presented as being solely about patient care. | |
| "Communities facing hospitals closures will be asking why these 'reconfigurations' are being made at a time of severe cost-cutting." |