One option is for a "super hospital" at Carlisle

The NHS in the area is looking at four options for the future of the services to improve them for patients and staff.

One option is for a "super hospital" at Carlisle's Cumberland Infirmary which would mean Whitehaven's West Cumberland Infirmary would be downgraded.

However, managers say that option has only been included at this stage to show all routes are being considered.

North Cumbria Acute Hospitals NHS Trust chief executive Marie Burnham said it was there to show that two hospitals are needed in North Cumbria.

She said: "That option is in there, in my view, to demonstrate to the rest of the country, particularly London, that rural healthcare is different.

Public consultation

In a briefing letter to staff, Ms Burnham and North Cumbria Primary Care Trusts chief executive Nigel Woodcock say if they do not plan the strategic direction of services, they will end up with a situation "where we cannot provide safe services in parts of North Cumbria".

Other options are to keep things as they are at the moment or look at changes to services at one of the two hospitals.

All the options will now be thoroughly looked at and tested by groups made up of doctors, patients, clinical representatives and planners.

That work is due to be completed by autumn 2004 when one preferred option will be put forward for full public consultation.

The NHS says it is keen for as many people as possible to have their say on the options.