Far-reaching hospital reconfiguration proposals for south east London have been approved by health secretary Alan Johnson.

The plans, affecting Bromley Hospital, Queen Elizabeth Hospital, Greenwich, Queen Mary’s, Sidcup, and University Hospital Lewisham, were referred by two council overview and scrutiny committees.

Alan Johnson today said he accepted that the changes were right, including that a midwife-led maternity unit should be retained at Queen Mary’s, contrary to the original proposal by the PCTs

The area’s primary care trusts had proposed closing the accident and emergency department, maternity services and inpatient paediatrics at Queen Mary’s, while expanding its urgent care centre.

Alan Johnson today said he accepted proposals from the independent reconfiguration panel that the changes were right, including that a midwife-led maternity unit should be retained at Queen Mary’s, contrary to the original proposal by the PCTs.

He said in a letter to councillors: “Having taken both the [committees’] concerns into account and having carefully considered the advice of the IRP in full, I am satisfied that the proposals are in the interests of the local health service and service users.

“However, the IRP has made a number of recommendations… all of which I fully support, and I expect the local NHS to follow them.”

The panel recommended that “urgent work takes place to agree the clinical and patient pathways to achieve a seamless service across primary, secondary, community and social care… before changes are made to hospital services and that estates and planning work to accommodate the proposals be undertaken as a matter of urgency”.

There should be a reassessment of the financial viability of the plans, called A Picture of Health.

In 2007-08 the four trusts involved – which, except Lewisham, merged to form South London Healthcare trust last month – had a combined deficit of £20.4m and an accumulated debt of £121.5m

NHS Bromley chief executive Simon Robbins, senior responsible officer for the programme, said in a statement: “This decision means we can move forward with certainty.

“Our teams of doctors, nurses and others will now finalise their plans to improve services for patients across south east London.

“Patients will notice the first changes quite soon, and over the coming months the programme will deliver all of the benefits which we set out.”

NHS London chief executive Ruth Carnall said: “This will improve services and address long-standing problems in south east London.

“The challenge now is to get momentum behind the development of truly first class healthcare so that local people can see that these changes mean real improvement.”