A former vice- president at the Royal College of Surgeons said years of underfunding is partly to blame for moving vital hospital care away from busy towns.

Consultant facial surgeon John Williams, who treats patients in Worthing and Chichester, said the Government did not have the cash to constantly invest in smaller hospitals.

Instead, Mr Williams said, financial pressures meant health managers now had to look to grouping medical specialities together at larger centres because of a lack of investment.

He spoke of his fears about the possible shift of some accident and emergency work to Brighton with pressures of congested roads.

Mr Williams said: "The money has not been spent on hospitals in the past. Our argument now is for quality of care. Patients might have to travel further, but they are travelling to the right services to look after them."

The royal colleges, groups of senior specialists who set standards for hospitals, have said they will not send junior doctors on to wards for training unless they know they are at a hospital where they will see a sufficient number of cases to improve their skills.

A recent Royal College of Surgeons' report said people in severe accidents were dying because some trauma centres did not have enough resources. It recommended specialist centres should be developed to care for bigger geographical areas. A review board representing health trusts in Mid and East Sussex is considering moving emergency surgical cases from the Princess Royal Hospital, Haywards Heath, to the Royal Sussex County Hospital, Brighton, or Redhill. Problems have also been heightened by a shortage of NHS staff.

The Argus has been campaigning against any plans to downgrade accident and emergency services at the Princess Royal.

Mr Williams added: "This is not a question of closing hospitals. It's a question of how to distribute the workload."

Mid Sussex district councillor Anne Jones, who also speaks for a Health Users' Group for the area, said the royal colleges were concentrating on the needs of doctors when the NHS needed to focus on patients.

She said: "Prompt treatment is absolutely vital in saving lives. The Royal Sussex is already on overload."