19 February 2013 Last updated at 18:49
NHS North West London A&E units downgraded
Accident and Emergency (A&E) units at four London hospitals are to be downgraded.
The moves affect Charing Cross, Central Middlesex, Hammersmith and Ealing Hospitals.
More serious emergencies will instead be referred to A&Es at Hillingdon, Northwick Park, West Middlesex, Chelsea and Westminster or St Mary's Hospitals.
The decision was confirmed at a joint committee of Primary Care Trusts in Westminster.
'Second-class'
NHS North West London said the changes would save money and improve care.
Andy Slaughter, Labour MP for Hammersmith, said the decision left a "second-class health service for millions of Londoners" and that the A&Es left would be "over-crowded and over-run".
Julian Bell, leader of Labour-run Ealing Council said: "We are going to fight this decision all the way."
He said statutory powers would be used to refer the decision to the secretary of state for health.
"We will also keep our options open with a judicial review," he added.
Those hospitals losing the A&E units will become "local hospitals" providing urgent care centres, outpatient and diagnostic services, while the five other hospitals will provide A&E services and become "major hospitals" providing specialist care.
'Best care'
Dr Mark Spencer, medical director of North West London NHS, said: "What we are recommending across north-west London is that we develop five bigger, better hospitals than we have at the moment.
"We can have consistently large teams of consultants making sure people get the very best care and in return for that we need to make some of our hospitals smaller designed around the services they need for their local community."
Bridget Ogden, campaigner at Ealing, said: "... When something can be done safely in the community, let's do it in the community, but you have got to have those facilities in place first.
"I have a real fear that [the health officials'] vision is going to turn out to be a nightmare for the health of the people of Ealing".
Four A&E units in north-west London recommended to close
NHS bosses have confirmed plans to close four A&E units in north-west London.
Hammersmith, Ealing, Central Middlesex and Charing Cross hospitals will all have their A&E departments replaced by urgent care centres if the proposal is approved.
It is argued that patients will get better care in bigger specialist hospitals but campaigners have reacted with anger saying their local medical services are under threat.
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