“Long ambulance journeys do not lead to more deaths,” said Sir George Alberti, the former national director for emergency access.
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Given the number of "traffic calming" measures my stupid local authority has put in, I think the above comment is laughable nonsense and completely disingenuous. If i have been stabbed, being buffeted around strapped to a trolley in the back of an ambulance for 45 minutes seems a pretty stupid way to treat me.

phil, London, uk

You might be OK to travel miles if you're in an ambulance whilst receiving specialist attention, what about if you're not?

If you're in pain/distress with an injury that needs medical treatment, of unknown urgency, where are you supposed to go?

VinceT, London,

Since we already have ambulance stations distributed all over, response times should not be affected.
That's fine if properly resourced minor injury units are provided, which they're not so far. As an example last Summer my son fell off his bike on holiday in Cornwall but as it was a Saturday the local x-ray unit was shut so we were sent off to the ONLY A&E unit in Cornwall at Truro where, being a minor injury, we were low priority so had to wait hours. For an injury that happened at 1pm we finally got back to our camp site at 3am.
We also used to have a local minor injuries unit in Epsom open 9-5 Monday to Friday, which was pretty useless.
If we have 24-hour minor injury units with supporting X-ray 24-hour 7 days a week then it may actually be an improvement.

Rich, Surrey,

Surely a ambulance journeys is in two directions, to the sense of an incident and then to the hospital. If the hospitals are further away the reaction times are longer and more people will die as a result. Even a simple journalist could understand this - couldn't they ?

simon daglish, London, England

Not all ambulances are crewed by highly trained and qualified medics as a recent TV documentary highlighted, plus of course is the access problem for relatives. An A&E department would sanction against those close relatives who probably do not have easy means of travel and so deny the patient the sort of support which is most valuable at times of trauma.

alan frankcom, solihull, west midlands.

“Long ambulance journeys do not lead to more deaths" says a spokesman. Maybe not, once you're in one. But where are the ambulances based? If they're all at the reduced number of A&E hospitals, then the longer wait before the ambulance arrives will certainly lead to more deaths.

kangxi, Hangzhou, China

A knock-on effect of A&E closures is that a patient could end up in a hospital up much further from home. If this patient is then hospitalised there, family visitors would be faced with much longer (car) journeys unless the patient is admitted to his local hospital after A&E care. So it's the subsequent hospitalisation arrangements that also needs to be taken into account.

R A Connell, Guildford, Surrey

As an Emergency Department Consultant in an average sized DGH I may be accused of having a vested interest, but some of the spurious nonsense espoused by the DOH and its so-called "Tzars" cannot pass without comment. There is absolutely no doubt in my mind that mass closures of Emergency Departments as suggested in your reports today would be financially rather than clinicaly driven. The condition most quoted to justify such closures is stroke, and specificaly the administration of "clot busting" drugs to reduce the permanant damage that can result from this devastating disease. Whilst much of the evidence regarding the efficacy of this particular treatment is patchy the one thing that has been identified as being critical is the administration of the drug within 3 hours of stroke onset. There is no evidence that the drug cannot be administered safely in "normal" emergency departments closer to the patient, indeed the same drug is used routinely in the treatment of heart attacks.

Dr R Bailey, Chesterfield, Derbyshire

"“Long ambulance journeys do not lead to more deaths,” said Sir George Alberti, the former national director for emergency access."

So why do we have air ambulances?

Dan G, Reading,