Published: 21/03/2002, Volume II2, No. 5797 Page 7

A district general hospital is likely to be stripped of many of its services after controversial reconfiguration plans were backed by the trust board.

Following a nine-and-a-half hour board meeting, East Kent Hospitals trust called for more medical and diagnostic services to be retained at Kent and Canterbury Hospital, but broadly approved an option which would radically downsize the hospital.

The four options proposed by East Kent health authority all reduce services at the Kent and Canterbury and centralise them at the trust's two other hospitals in Margate and Ashford; the A&E department in Canterbury is replaced by a minor injuries unit under all options. East Kent HA will meet next Monday to decide how to proceed - but with only days left before it is replaced by the new Kent-wide strategic health authority, its role will be limited.

David Shortt of pressure group Concern for Health in East Kent said: 'We are looking very seriously at legal action - a judicial review. We have been talking to lawyers for the last couple of days.

'It is extremely unreasonable that East Kent HA will make the final decision on this three days before it is abolished.'

A major reconfiguration of hospital services in the area has been on the cards since the mid-1990s.

Former health secretary Frank Dobson laid down ground rules limiting options for changes in 1998, but East Kent HA argues that national service frameworks, clinical governance and other changes have affected what would be a viable and sustainable solution.

The plans have already been pored over by Kent county council's pilot NHS overview and scrutiny committee - thought to be the first in the country to consider a major reconfiguration.

The committee set up its own select committee, which took evidence from the trust, HA, campaigners and experts at a series of meetings. Members of the select committee also met Dr Richard Taylor, the Wyre Forest MP who fought to retain services at Kidderminster Hospital.

The select committee could not agree on any options put forward, though a majority of members preferred the one which retained most services at the Kent and Canterbury. But the committee called for:

urgent investment in all three A&E departments;

services to be centralised only where there are benefits for patient care;

cancer services to be retained at the Kent and Canterbury.

The committee stopped short of calling for A&E services to be retained in Canterbury. But the Royal College of Nursing in east Kent is calling for an independent reconfiguration panel to look at the future of hospital services. It is critical of the HA's consultation document, saying it lacks evidence to back up its proposals and has failed to win over local people and clinicians.

But the consultation exercise has showed up the difference in timescales between local councils and the health service. East Kent's public consultation was meant to end on 28 February. The council's scrutiny committee was only able to produce a verdict in midMarch and that has still to go before the full council. Though these procedures may be streamlined in future, it will be hard for them to follow a select committee pattern - calling and questioning witnesses - within the normal NHS timescales for consultations.