Health Minister Andy Kerr defended changes to the NHS in Scotland

That is despite warnings from opposition parties that accident and emergency cuts would cost lives.

The Conservatives raised the issue of proposed closures - such as the loss of the casualty units at Ayr and Monklands hospitals - in a debate at Holyrood.

Mr Kerr said: "I stand in the interests of patients." He said he aims to shift the balance of care to communities.

The minister said plans aim to streamline emergency medicine, with most care provided in community casualty facilities.

Specialised accident and emergency (A&E) departments would deal with more seriously-ill patients.

'Lives lost'

Mr Kerr said he did not underestimate the strength of local feeling around some of the changes.

"The changes we must make provide a sound basis for the delivery of safe, sustainable high-quality service into the future," he said.

The Scottish Conservatives put forward a motion urging the Scottish Executive to re-examine decisions on A&E facilities in Ayr and at Monklands Hospital in Airdrie.

Tory MSP John Scott , for Ayr, said: "Consultants at Ayr hospital have warned that lives will be lost.

"Time-critical accident and emergency care should be delivered locally."

'Extreme folly'

Mr Scott claimed on Monday night, 20 people who were taken into A&E at Crosshouse Hospital were left lying on trolleys while they waited for beds to become available.

He said on Tuesday 2 January, the A&E department at the Kilmarnock hospital was completely closed "due to the inability to cope with the demand".

SNP health spokeswoman Shona Robison branded the closures "extreme folly" and urged ministers to think again.

Changes to accident and emergency departments provoked debate

She said Monklands was one of the best performing A&E departments in Scotland.

This week, Wishaw General had to close its doors to all but the most severe cases due to a 64% increase in patient numbers.

"How much worse is a repeat of these winter pressures going to be with only two A&E units operating in the area?" asked Ms Robison.

Carolyn Leckie, of the SSP, said NHS Lanarkshire had the second highest PFI commitments in Scotland with �42.7m due in 2006/07 alone.

"Much of that goes to shareholders and dividends rather than it being invested in public services," she said.

Liberal Democrat MSP Euan Robson said the decisions had been taken and should be made to work.