During a speech to an Institute of Health Services Management conference yesterday, Sir Bernard warned that any strategy should avoid, if possible, a number of closures coming together.
But he added later that if Virginia Bottomley, Secretary of State for Health, accepted his recommendations they could take up to a decade to implement, particularly if some of the changes required new building work.
However, he also said it was essential that the Government weighed the decision with great care. 'If you take a decision that a hospital is going to close it would be extremely difficult to go back. The process needs to be managed extremely carefully.'
Sir Bernard welcomed the consultation process now being conducted by Dr Brian Mawhinney, Minister for Health, who is canvassing views and objections among all the hospitals affected by the report's proposals before a final decision is made in January.
'Those affected who do not believe it to be correct must come up with their own proposals,' he said. 'They must contend the process and I would entirely agree with that.'
But he issued a blunt warning to Mrs Bottomley that it was not feasible that the Government should take no action, as primary and community health care would deteriorate further. 'Problems in the general practices and community care would worsen. As in-patient stays decrease a number of major hospitals would become non-viable,' he said.