A new community casualty unit will be created in Monklands by 2010

Professor Allyson Pollock, of the University of Edinburgh, said the move to downgrade Monklands Hospital was driven by financial pressures.

She said: "These issues are not being driven by public health need but by short-term cash problems."

Deputy Health Minister Lewis Macdonald rejected the claim and said �100m would be invested in Monklands.

The Scottish Executive has endorsed NHS Lanarkshire's plan to downgrade the Monklands accident and emergency unit.

There is a huge pressure on the budget in Lanarkshire health board and they are under major pressure to do something about it Professor Allyson Pollock

The health board argued the area could only justify two A&E units - at Hairmyres Hospital, East Kilbride, and at Wishaw Hospital.

But Professor Pollock, of the University of Edinburgh's centre for international public health policy, claimed the cost of meeting Private Finance Initiative (PFI) bills was a factor in the Monklands decision.

She said the Lanarkshire health board faced "serious financial difficulties" and the problem of having to make good a deficit of between �20m and �30m.

Every year it had been trying to achieve that by cost savings from services and selling off land and buildings, she claimed.

'Public debt'

She said: "There is a huge pressure on the budget in Lanarkshire health board and they are under major pressure to do something about it.

"The problem is, they have less and less land because they've sold off Hairmyres, they've sold off Law - they've really sold off the family silver.

"The only bit of family silver that is left is Monklands in public ownership.

"The second problem for them is that part of the pressure on the budget is PFI charges for the new hospitals at Hairmyres and Law."

Spending on health services in Lanarkshire will be greater as a result of the adoption of these proposals Lewis Macdonald MSP Deputy Health Minister

She added: "PFI isn't new investment, it is debt and it is debt the public is saddled with for 30 years."

This view was rejected by Mr Macdonald, who said her figures were out of date.

He said Lanarkshire health chiefs had assured him their books would balance by the end of this financial year, regardless of whether the board's proposals were accepted or not.

"This is not about balancing the books, it's not about selling the family silver - it's about modernising the health service and ensuring the people of Lanarkshire have access to the same quality of healthcare as those in the rest of Scotland," he said.

The minister said that under the changes, there would be two A&E units and five "community casualty units", one of them located at Monklands.

And he denied the changes were prompted by financial considerations.