Health campaigners fear key services at St Helier Hospital are under threat, after the NHS suggested accident and emergency (A&E) and maternity wards in London could close.

NHS South West London (NHSSWL) has launched a review of its services in the face of massive budget cuts.

Reports published by the NHS trust last week suggested fewer A&E departments and maternity awards as one solution because of a lack of senior doctors.

Health campaigners have said the review has put the services at St Helier under particular threat because it comes at the same time as a proposed merger between St George's Hospital and St Helier.

Critics of the merger have previously warned it could become a "hostile take-over" that sees St Helier asset stripped as it battles a multi-millionpound defecit.

Now with NHSSWL suggesting A&E and maternity services could be run out of less sites in the capital, campaigners have said the merger has made the hospital particularly vulnerable.

Geoff Martin, from healthcare watchdog London Health Emergency, said: "We have said all along a merger with St George's left St Helier staring down the barrel if there were cuts to maternity and healthcare services in South West London."

Mr Martin said: "People should be under no illusion that we face a real fight on our hands to save these key services at the hospital."

St George's A&E department is the only one in South West London to currently meet standards for senior doctor presence.

Councillor Colin Stears, Sutton Council's spokesman on health, said: "These reports raise fresh questions over the future of the A&E and maternity units at St Helier but our residents can be reassured that we will fight tooth and nail to retain these services.

“St George’s maternity unit is already at full capacity and simply cannot cope with any more cases, so it is essential that St Helier’s maternity unit - and a 24/7 A&E unit - are maintained."

Dr Howard Freeman, NHSSWL joint medical director, said the draft reports were only suggestions, and not yet location specific.

Services at St Helier Hospital St George’s Healthcare NHS Trust formally submitted their bid to merge with St Helier Hospital in November.  The bid is currently being assessed against a range of criteria aimed at proving how, by merging with St Helier, they will improve healthcare services for local people. A final recommendation is expected in early 2012.

  Dr Ruth Charlton Epsom and St Helier NHS trust’s Joint Medical Director, who sits on the board that will make the final decision on the St George's merger, said: “It is important to remember that this process is not about changing services: it is about who runs St Helier Hospital in the future.  “Importantly, should St George’s be selected to merge with St Helier, they will have to run all the services that St Helier currently provides, including A&E (accident and emergency) and maternity.”

When asked about the Better Services Better Value review, which involves clinicians from across south west London, Dr Charlton added: “We know that there are many areas of excellence across our Trust, which is why our hospitals have some of the lowest mortality rates in the country.

"However we recognise the challenges facing the NHS locally, including rising demand for our services, tougher guidelines for delivering care, difficulties recruiting key clinicians and the need to save money.

“As such, our doctors, nurses and other healthcare staff are heavily involved in the Better Services Better Value review and will undoubtedly play a significant role in shaping the final outcome.

“It’s important to remember the draft clinical reports from the Better Services Better Value review are not final, nor are they consultation documents. "They set out the challenges facing local health services, but it is too early to start talking about any proposals for changes to any local hospitals.”

The merger is totally separate of the NHSSWL review.