PATIENTS and visitors from outlying areas could face long and expensive journeys to hospital under a proposed health shake-up.
Councillors are worried about the impact that plans for County Durham's hospitals will have on people without cars.
Health chiefs are considering creating one NHS trust for the county by merging the existing North and South Durham trusts.
The hospitals - Bishop Auckland General, University Hospital of North Durham, Darlington Memorial and Shotley Bridge - would specialise in a particular field of medicine and serve the whole area.
Durham County Council's cabinet has welcomed the plans, saying they could ensure a consistent service is provided across the county.
But there is concern about the additional travelling patients and their relatives face.
David Marshall, councillor for Craghead and South Moor, near Stanley, said many people in Derwentside area would face long journeys if they had to travel to Bishop Auckland.
Cabinet member Christine Smith said: "There are concerns about travelling, that's one of the big things local people will worry about.
"Balanced with that is the actual expertise to carry out the more major operations.
"If we can have that expertise in County Durham at centres of excellence, rather than people having to travel outside, that is better."
Under the proposals, University Hospital will take the lead for vascular and diagnostic angiography services, Darlington will focus on acute obstetrics and gynaecology, and Bishop Auckland will have a centre for planned surgery.
Shotley Bridge will be developed as a diagnostic centre.
Social services director Peter Kemp said problems with travel were outweighed "by the advantages of creating centres of excellence which will attract good quality medical staff and consultants and facilitate specialist training resources to improve staff retention prospects".
The council, which is being consulted on the proposals, will consider a further report next month.
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