SENIOR Winchester doctors say they welcome the closer working relationship with Southampton even though proposed closer links will mean reduced services such as emergency surgery at the Royal Hampshire County Hospital.

Concerns have been raised that eventually other services at the RHCH could be threatened, including the accident and emergency unit. The doctors say they are very conscious of the potential risks.

"We must avoid the real possibility that ill-thought through changes could create a less accessible, more expensive and lower quality service," said Paul Gartell, chairman of the medical staff committee at the RHCH, and Chris James, medical director in a letter to the press.

They said the possible loss of emergency surgery facilities at Winchester may have serious effects on emergency medicine, paediatrics, obstetrics, gynaecology, radiology and intensive care. They all rely on cross-referral, advice and treatment 24 hours a day.

Hospitals such as the RHCH face growing problems. They are increasingly expensive to run.

Surgery is becoming more specialised and there is an absence of back-up expertise such as neurology and thoracic surgery to deal with patients who are brought to A&E with multiple trauma.

"Historically these smaller hospitals, and particularly Winchester, have had a reputation for providing high-quality care in a rather more patient-friendly environment than the large teaching centre.

"The fact that local health economy is overspent and the two local hospitals are only 13 miles apart, has raised the question of the possibility of savings through rationalisation of services.

"We welcome this approach and fully support any initiative which will improve the efficiency, access, delivery and quality of service."