ACCIDENT and emergency services as well as maternity care are set to be axed at a historic hospital after public consultation.

Acute, high risk health care at Queen Mary’s Hospital, Sidcup, will be replaced by more elective surgery and outpatient services in a shake-up of of the NHS in outer south east London.

Public consultation on the complicated and controversial proposals is due to begin on January 7, subject to senior NHS managers signing off the documents this week.

The public will be presented with three options, all of which envisage Queen Mary’s being reconfigured as a non acute ‘borough hospital’.

Its modern counterparts in Bromley and Woolwich would become major trauma and surgical emergency centres under all three options.

The future role of Lewisham Hospital could range from a third major emergency hospital to a second borough hospital similar to Queen Mary’s.

The consultation would run until April 7, with a decision expected in June.

Simon Robbins, chair of the project called A Picture of Health, said Queen Mary’s was not a financially viable emergency hospital for the future due to its small size and age compared to the other three hospitals.

He said: “We’ve got to make some changes to make services safer, more appropriate and more affordable. What we’re not going to do is end up fudging the issue or leave ourselves with a continuing financial problem.”

The shake-up was triggered by the NHS’ mounting debts in south east London, but medical directors at all four hospitals argue that centralising acute care and bringing non emergency services such as diabetes into community clinics is in patients’ best interests.

Dr Roger Smith, medical director at Queen Mary’s, said: “Most people understand that by concentrating the service, the evidence is that we get better outcomes.”

European working laws which take full effect from 2009 will reduce junior doctors’ working hours, thereby making the current system of four district general hospitals serving a population of one million people unaffordable, Dr Smith said.