Thousands of people brought Ealing to a standstill on Saturday in protests against plans to axe A&E, maternity and intensive care departments at four hospitals across west London.
Anti-cuts protesters brandishing Save Our Hospitals and Hands Off Our Hospitals placards joined one of two marches from Southall Park and Acton Park before the 5,000-strong demonstration joined forces for a rally at Ealing Common.
NHS north-west London is proposing to downgrade services at four of the nine hospitals in the region and warned more than £300 million in debts will be racked up by 2015 if the changes do not go ahead.
Accident and emergency departments at Charing Cross, Ealing, Hammersmith and Central Middlesex Hospitals have all been earmarked for closure under NHS reorganisation plans.
St Mary's, Chelsea and Westminster, West Middlesex, Northwick Park and Hillingdon would would also see significant changes to their roles.
The proposals outlined in Shaping A Healthier Future consultation document is being taken forward by eight clinical commissioning groups made up of GPs representing NW London's eight primary care trusts.
But campaigners, politicians and unions argue that the cuts will devastate care in the area.
Speaking at the rally GMB national health officer Rehana Azam said the changes are part of the wider agenda of cuts and reorganisations imposed by the government.
She predicted that waiting times would soar and patients would have to travel further for urgent treatment.
And GMB regional organiser Tony Hughes commented: "The coalition said the NHS will never be messed around with, that they will never cut services.
"If these proposals go ahead some 700,000 people who live and work in these parts of London will see a dramatic change to the NHS services provided.
"Other hospitals in London would have to and try and take the strain.
"As they are already working flat out this will impact on the public in longer waiting times for ambulances, longer waiting times at A&E departments, and with the closure of maternity and intensive care units it is only a matter of time before lives are lost."
A rally in Hammersmith originally set for Saturday September 22 has been rescheduled to Saturday October 6.
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