Jeremy Laurance: Lansley faces landmark decision over NHS closures

There is continuing disquiet over a reduction in patient choice

Andrew Lansley is to meet local MPs and the council in Enfield, north London, this week in what is being seen as a test case for hospital closures across the country. The Health Secretary has to decide whether to block plans approved by NHS London to close the A&E unit at Chase Farm Hospital, first proposed 17 years ago, and transfer maternity and children's services to North Middlesex Hospital, six miles away.

He announced a moratorium on closures following the election, after Tory MPs opposed re-organisations across the country during the election campaign. There is now a pent-up bulge of at least 25 planned "reconfigurations", and the decision on Chase Farm will signal to the NHS whether it can re-organise services to save cash and improve care.

The proposals for Chase Farm are deemed by NHS London to have met the "four tests" laid down by the Government: they are supported by patients and the public; they take account of patient choice; they are approved by local GPs; and they are based on sound clinical evidence. But there is continuing disquiet over a reduction in patient choice.

A Department of Health spokesman said: "Any change to NHS services must be to ensure patients get the best care possible, delivered to the highest standards."

Mr Lansley is expected to allow the closure to go ahead. If he does not, all bets are off on the capacity of the NHS to survive the coming financial squeeze.