How far is too far?

Many acute trusts in England are currently considering reconfiguring some of their services. All over the country battle lines are being drawn as patients and doctors fight to save local hospitals, and in one case the dispute has become so intense that the health secretary has been called in to make a judgment.

One of several changes proposed by Oxford Radcliffe Hospitals NHS Trust is to close its consultant led obstetrics department at the Horton General Hospital in Banbury and replace it with a midwife led birthing unit, which would be the country's largest such unit. The trust argues that change has come because of long held concerns over the long term safety and sustainability of medical staffing of children's services at the Horton. It claims the changes overall will cost the trust an extra £593 000 (€893 000; $1.2m) annually, alongside a capital programme of £7m investment at the hospital, but those opposed to the changes have questioned the figures and believe cost cutting is playing a part in the trust's motives.

These plans have led to strong opposition, as shown by a four month consultation held last year, a petition opposing the changes signed by more than 15 000 people, and a statement condemning the move signed by 86 general practitioners. …