FIVE options on the future of Kent and Canterbury Hospital - due to go out this month to public consultation - have been reduced to four. The original option one, to leave things as they are, will not now form part of the choices.

Liz Cracknell told the East Kent Hospitals NHS Trust that to do nothing was impossible.

"Only four options are deliverable," she said. One option is that endorsed by the former Secretary of State for Health Frank Dobson and the other three are a variation on that, Mrs Cracknell said.

"Most of the options are similar, with small variations," she told the meeting. An internal appraisal of the options did not come up with a clear choice, but there was concern about the Dobson one, she said.

She revealed that about 220,000 leaflets giving brief details of the options available would be distributed.

A longer, traditional consultation document would also be produced with a more limited distribution, although it was there for anyone who wanted full details of what was proposed. Details would also be on the web site.

Patient and public groups would be contacted with details and 11 public meetings will take place towards the end of January. "We are expecting a large number of responses and all of those will be collated," Mrs Cracknell said. "We will be consulting on four options because the do minimum one is impossible to deliver.

"We have to tell people why services have to change. There are still people who believe that things can be left as they are and we have to explain that they cannot."

The three-month consultation will take place through Christmas and the New Year. Hospitals trust chief executive David Astley said it was important that people realised that the 24-hour accident and emergency unit at Kent and Canterbury Hospital would be going whatever. Mrs Cracknell said none of the options provided easy answers for east Kent's healthcare.

Sally Murch, a member of Canterbury and Thanet Community Health Council, said: "The facts were slanted in the last public consultation document so I hope that this time it will be made clear because the public is suspicious."

Mr Astley said there was more openness now and that was a big difference. "In this consultation we are talking about a specific range of issues, which are part of a wider reorganisation process because we cannot stay as we are," he said. "The whole issue is not being opened up for debate. There are four options on the table."