The doctor at the centre of a review which could see Kingston Hospital lose its A+E and maternity unit has pleaded for more time to draw up proposals.

Dr Martyn Wake, joint medical director of Sutton and Merton Primary Care Trust, but who lives in Kingston, was questioned by MPs and councillors at a health scrutiny panel in Kingston on Wednesday evening.

He said: "At the moment what we are asking for is time and space to work up our proposals in a much better level of details in order that we can present them to you in more details later on this year."

He also challenged extracts from a confidential document leaked to Kingston and Surbiton MP Edward Davey which shows clinicians had agreed that the number of hospitals with A+Es and maternity should be reduced from four to three.

In a table with 18 options for the hospitals, 16 involve the loss of a major service at Kingston.

Dr Wake said: "I find it very difficult there has been a suggestion we are going to close A+E services and obstetric services at Kingston Hospital.

"I think that's an allegation you just can't get out of the document we have produced.

"If this seems defensive, we certainly have no intention to mislead."

And his colleague Sian Bates, chairman of Healthcare for South West London, said: "To go out with an incomplete story to the public is not what the public would want. I do hope the Case for Change which we have outlined and will be published will give the people the context and complexity of issues."

Earlier in the meeting Dr Wake presented both clinicial and financial reasons for changing the way healthcare works in south-west London.

He said: "What we are seeking to do is much better quality. Some of it is about money. It is cost effective.

"Even clinicians realise they have got to be accountable for what they spend.

"We are estimating that if we continue to spend at the current rate there would be a considerable effect - £300m is our best estimate at the moment."

And he said they would follow General Nursing Council guidelines by having a consultant paedatrician on call on every maternity ward.

He said: "I don't think there's anywhere in London that has that 24/7, with consultants present on the labour ward.

"Our area, Kingston, currently provides a very high level of cover - around 98 hours a week.

"The reason this is an issue is we don't have a large number of obstetricians to provide this care.

"Therefore part of the work we are doing is to work out how we can best deliver that care to the highest standards."

In urgent care he outlined plans to shift 58 percent of A+E activity to urgent care centres outside of the hospital.

Only 40 percent of people would carry on going to A+E with two percent of attendances avoided.

He also talked about moving planned operations out of hospitals, praising the work of the South West London Elective Orthopaedic Centre (SWLEOC) at Epsom which performs routine operations like hip replacements.

Dr Wake said: "Patients would now be shocked if you suggested them having it done anywhere else."

And he promised St George's Hospital would not be "protected" from changes despite its designation as the major acute hospital for south-west London.

"I can assure you changes are already occurring", he said.