Ayr Hospital, whose casualty department faces a status change

If agreed, the move would result in the accident and emergency department becoming a community casualty unit.

It would mean that all major emergency incidents would be dealt with at Crosshouse Hospital in Kilmarnock.

But the proposals by have been strongly criticised by the local Conservative MSP John Scott, who said he would fight them "tooth and nail".

NHS Ayrshire and Arran said that a vision for the future of the Scottish NHS, drawn up in May by Professor David Kerr, suggested services should be improved and kept local, rather than cut.

The switch to Crosshouse Hospital, which would be the only specialist casualty unit in Ayrshire, could add 30 minutes to some patients' journeys.

The plans would also create "community casualty units" at Davidson Hospital in Girvan, East Ayrshire Community Hospital in Cumnock and Ayrshire Central Hospital in Irvine.

They would be staffed by clinical personnel such as nurse practitioners. Ayr Hospital would retain an extended hours community casualty unit.

These proposals are all about improvement, it is not about cutting or downgrading anything Bob Masterton NHS Ayrshire and Arran Reforms call in Kerr review

Mr Scott said some patients would struggle to find Crosshouse Hospital because it was not easily accessible.

"NHS Ayrshire and Arran have gone too far in threatening to axe one of Ayrshire's two accident and emergency departments," he stated.

"I am very angry indeed that Ayr Hospital is once again the target. Ayr Hospital's casualty department can be very busy indeed.

"I am not prepared to sit back and see a further erosion of our local health service."

Services 'deteriorating'

He said the shake-up plans followed a decision last year to close the hospital's paediatric department and move children's inpatient services to Crosshouse.

"Clearly the health services available to the people of South Ayrshire are deteriorating rapidly, but the withdrawal of A&E cover would be the final straw."

The hospital was the closest to Prestwick Airport, HMS Gannet and was on the A77, which had a high accident rate.

Ayr Hospital is near HMS Gannett, home of rescue helicopters

Health board executive director Bob Masterton replied that the MSP did not accept the offer of a meeting about the proposals.

He said: "I made that offer on 16 August and regrettably he didn't take it up, so unfortunately I fear he's been mis-representing the proposals that are going out to consultation.

"These proposals are all about improvement, it is not about cutting or downgrading anything.

"They will improve it because people throughout Ayrshire will be able to get faster access to minor injury and illness services closer to their homes.

'Longer journeys'

"All of the proposals that we're going out to consult on, all of the options that we considered, actually will require significant additional investment.

"This is not cost-cutting. This is investment in the health of the people of Ayrshire and Arran."

But Mr Masterton admitted that the move would lead to longer journey times.

The plans have been worked up with the ambulance service

"It's recognised that this reorganisation would have travel and access consequences for some patients for acute care and equally for some patients for elective care.

"I do, however, want to stress that the plans have been drawn up with the full support and backing of the ambulance service who are very comfortable that they can, with the right investment, deal with this issue.

"The two hospitals are just 20 miles apart on a very good road link."

Health administrators agreed on Wednesday to consult on the plans for the hospital, which opened just 13 years ago.