Scotland's cabinet secretary for health and well-being has committed to providing services as locally as possible, saying there should be 'an assumption against centralisation of services'.

Nicola Sturgeon, who is also the deputy first minister in the new SNP minority government in Scotland, has already halted the closure of two accident and emergency units since taking up her post after the elections in May.

She told delegates at the NHS Confederation conference: 'At the heart of [our] approach will be a determination to provide services as locally as possible.'

'That's not to say there will never be occasions when it makes sense to concentrate services for the benefit of patients,' she said, but any proposals to centralise services will be 'subject to robust independent scrutiny to ensure that they have taken the views of local people into account', she said.

The minister said patients 'are the drivers of change' and the Scottish Executive will be looking to introduce an element of direct election to local NHS boards.

Ms Sturgeon stressed her party's opposition to stimulating competition. 'We reject the very idea that markets in healthcare are the route to improvement,' she said.

Ms Sturgeon also highlighted differences in the approach to the recruitment of junior doctors, saying in Scotland government had maintained 'a flexible and pragmatic approach'.

As Scottish ministers reflected on the lessons to be learned from this year's problems with the recruitment process, 'that determination to do what's right for Scotland will remain to the fore', she added.

The new executive had a 'much smaller, much more focused cabinet', she said, and an expanded Health and Well-being Department that includes a new minister for public health.

'That gives us a real opportunity over the next four years to demonstrate the benefits of working between rather than within the artificial divisions of government,' Ms Sturgeon said.

The executive would publish a detailed plan for action outlining how it would put its principles into action at the end of this year, she added.