By Paola Alvino MAJOR surgery of hospital services in Leigh and Wigan has been announced in response to local problems and national trends.

A draft document heralding dramatic change in the way services will be organised and delivered in the borough was put out for consultation this week.

Under the proposals, Leigh Infirmary could become a base for a range of new services designed to increase the number of patients looked after locally.

These include some outpatient and day cases, emergency care, vascular surgery and a satellite unit for renal services, including dialysis.

Drafted in response to staff shortages, lack of beds and budgetary problems, the proposals were described by health authority chief executive Tom Mann as having "enormous" significance.

"This is about people's empires, people's careers, people's aspirations. People tend to be comfortable with what they have done before so it will be difficult," he said, adding that a "fair and thoughtful" approach would be needed.

The policy centres on stronger links between services, more local care, shorter hospital stays, and more priority given to follow-up care, home visits and care in the community.

Dr Ian Caldwell, chairman of Bolton South East Primary Care Group, pointed out, "At the moment, if you live in Area A where there is low provision of a particular service, you are twice as likely to die than someone who lives in Area B where there is a much higher level of service."

Brenda O'Driscoll, Director of Service Strategy, said "major factors" had precipitated the climate of change.

"More people are living longer, there have been major and fast-moving developments in the technology of health care, and people's expectations have changed.

"When the NHS was first set up there was a feeling that people would be grateful for any services they got. That certainly isn't the approach now."