Doctors' leaders today denied they had made any agreement with the government in support of mass hospital closures.

The British Medical Association (BMA) said it had not met with ministers to discuss plans to shut up to 60 hospital departments in England.

A BMA spokeswoman said: "To suggest that we've thrown our weight behind this plan is scaremongering. There's been no discussion with ministers and no secret agreement."

The Observer yesterday reported that the BMA and the Royal College of Physicians had given their support to government plans for a massive "reconfiguration" of hospital services, providing community services were put in place first to replace them.

The paper reported the plans, drawn up to tackle the £512m deficit facing the NHS, would involve the closure of casualty departments, small midwife-led maternity units and children's centres in smaller hospitals.

The BMA spokeswoman said while there might be a strong case for downgrading some hospital units - turning accident and emergency departments into minor injury units, for example - it could not condone such action in advance of public consultation.

She said: "There's a danger if you close a big hospital unit the other departments wither away. We don't want to see that happen.

"There may be certain situations where community services could replace some hospital services in small towns, with big departments based in larger hospitals in larger towns. But it all depends on what local people want - and they might not want to have to travel to a large town for treatment."

The chairman of the BMA, James Johnson, said it was increasingly difficult for smaller hospitals to provide a range of comprehensive services, so it made sense to review what treatments they offered. But he warned against closures driven by cost cutting or political convenience.

He said: "Any changes to our hospital services must be based on delivering the highest possible care for patients. Reconfiguration to suit political needs or decisions based solely on cost would be completely unacceptable. Above all, we must ensure that patients have a say on how best to deliver health services in local communities."