The case for major reform of emergency treatment in the NHS and the creation of super A&E departments to treat heart attack and stroke patients has been set out in two reports by leading clinicians published today.

Tony Blair, speaking at an NHS Confederation conference in London, used the reports as an example of the need for NHS reforms and to say that accident and emergency departments must change in order to save more lives and give patients better care.

The reports, written by Sir George Alberti, National Clinical Director for Emergency Care, and Professor Roger Boyle, National Clinical Director for Heart Disease and Stroke, both argue that patients would be better treated at specialised heart and stroke units rather than a patient's local A&E department, even if it meant a longer journey.

Professor Boyle said that he expects to see 500 fewer deaths, 100 fewer recurrent heart attacks and 250 fewer serious complications like strokes, every year because patients will get swifter and more specialised treatment if the reforms are brought in.

In his report, he argues that paramedics would be able to assess a patient's condition and decide which hospital can give them the best treatment for their condition.

He dismissed claims by some campaigners that the reforms were being introduced to help save the cash-strapped NHS money.

Professor Boyle said: "By giving life-saving drugs to heart attack victims on their doorstep and using clinical judgements to by-pass A&E to deliver heart attack and stroke patients directly to specialists, we are acting only in the best interest of the patient. This is not driven by saving money but by the aim of saving lives."

Outlining the details of his report, Sir George said; "Every service cannot be offered by every A&E department - it never has been, and never can be - so it makes sense to create networks of care with regional specialist centres to give the best possible treatment to the sickest people."

The two reports have been published at the same time as a separate report by the Institute for Public Policy Research (IPPR) that argues that campaigns to save services in district hospitals could lead to 1,000 unnecessary deaths each year.

It says that complex treatments are better delivered by highly-trained staff at specialist centres, rather than spread more thinly around local facilities.

Richard Brooks, IPPR Associate Director, said: "Many people are understandably worried about local services moving away from their local district general hospitals. In particular, residents are concerned about access to care if they or a family member has a heart attack or a serious accident.

"But if heart attack and serious injury victims were taken past their local hospitals to a specialist centre, they would be significantly more likely to survive."

Today's initiatives come as a leaked memo discloses the Government's anxieties about winning the arguments for NHS reforms. The minute of a meeting between Patricia Hewitt, the Health Secretary, and other ministers, was published in the Guardian today.

"Too often the debate on public service reforms seemed to pitch the government against frontline staff", the paper quoted the minute, which was marked restricted.

The Prime Minister said today that the reports by Sir George and Professor Boyle "offer a compelling and vivid account of the changes that are taking place in modern health care." He told his audience of primary care bosses that life-threatening emergencies needed specialist treatment.

Mr Blair said: "If you have a rupture of a major blood vessel you need an experienced vascular surgeon with access to 24 hour laboratory services and radiology. The right care for strokes now is to have a CT brain scan within 3 hours, followed by aggressive rehabilitation with thrombolysis in appropriate cases.

"That level of expertise can't be offered everywhere. That is why it makes sense, alongside local provision, to create specialist centres of excellence, which have 24-hour consultant cover and access to state-of-the-art diagnostic equipment," he said.

However, health campaigners argued that instead of improving services, the reforms would put more lives at risk because patients would have to travel further for treatment.

Karen Jennings, head of health at the union Unison, said: "The climate of debt in the NHS puts the development of new policy under suspicion. We are extremely concerned that these policies may be being driven by deficits, not what is best for patient care.

"The key to developing new policy in the NHS must be asking the experts - the staff who work in it - and today's announcements have been made without any prior consultation.

"If we move towards more specialist units we still need to ensure that patients have access to really good local A&E departments."

Geoff Martin, of campaign group Health Emergency, said: "Claiming that closing local A&E departments, trauma units and intensive care facilities will improve services turns all logic on its head.

"People are fighting these closures in their tens of thousands up and down the country because they know that closing local services and increasing journey times puts lives at risk."

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