Published: 14/10/2004, Volume II4, No. 5927 Page 10 11

A major reorganisation at a Kent trust could see some services moved from a hospital and concentrated on a new site 17 miles away.

The proposals, which are at an early stage, are already creating anger in Maidstone, where the local hospital could lose inpatient children's services, consultant-led maternity services and emergency trauma work.

Maidstone and Tunbridge Wells trust is putting out a 'discussion document' for eight weeks which could lead to proposals that all emergency orthopaedic operations should be done at Kent and Sussex Hospital in Tunbridge Wells from 2006, while planned work is carried out at Maidstone.

Currently, elective and emergency orthopaedic work is carried out at both hospitals. Around 1,500 emergency cases done at Maidstone each year would have to be dealt with in Tunbridge Wells. But under separate proposals which went out to consultation last week, Maidstone Hospital would lose all complex births, its special care baby unit and inpatient children's services when a new private finance initiative hospital opens at Pembury, east of Tunbridge Wells, in 2010-11. This would replace the existing Pembury Hospital and the Kent and Sussex.

A midwifery-led unit would be retained in Maidstone, although not necessarily at the existing hospital, but this would handle only a fraction of the current 2,600 births.

The plans are similar to proposals for women's and children's services put forward four years ago but abandoned after public criticism. The trust argues that it needs to make changes because:

it is currently cancelling one in five planned orthopaedic operations on the day of surgery because of the demands of emergency surgery;

it has problems recruiting many specialist staff, such as neonatal nurses, and concentrating services in one hospital would help.

it has problems meeting requirements for junior doctors' hours.

Chief executive Rose Gibb said: 'It is 100 per cent clear from the doctors and nurses treating children and pregnant women that it is no longer acceptable to leave these services as they are.'

But Maidstone councillors have criticised the plans and the local newspaper has claimed it can take an hour to travel from Maidstone to Tunbridge Wells by car, two hours by public transport, and that the return taxi fare would be£50.

Ms Gibb said there were only three obstetric consultants based at Maidstone - not enough to maintain a rota. Concentrating services would aid recruitment.