RURAL ambulance services in the North-East are facing a major reorganisation.

Under controversial proposals, existing ambulance stations in places such as Barnard Castle, Middleton-in-Teesdale and St John's Chapel, in County Durham, could be closed.

Instead of two-man ambulance crews turning out to answer 999 calls during the night, they would be dealt with by a single paramedic in a car. If needed, the paramedic would call for an ambulance.

Bosses claim the new way of working would improve night-time ambulance cover for rural areas.

For many years the North East Ambulance Service (NEAS) has operated a "stand-by" arrangement at night in small rural ambulance stations. This involves staff who have been on duty during the day being available to respond to emergency calls from their homes at night.

Due to the low level of calls at night in rural parts of the region, the system has worked well for many years.

Under the new system, instead of having to wait for ambulance crews to make their way to their local ambulance station then drive their vehicle to the scene of the night-time call-out, the 999 call would be answered by on-duty paramedic.

NEAS officials stress that the proposals are at an early stage. To gauge reaction, they are asking for feedback from organisations and individuals in affected areas, including rural Teesdale, Weardale and Northumberland.

Last week's announcement by the Department of Health of sweeping changes to the ambulance service means that current working arrangements may have to change.

NHS Delivery Minister Lord Warner talked of taking the hospital to the patient rather than the patient to the hospital. Simon Featherstone, chief executive of NEAS, said: "The issue is not whether there is a need for change, but rather what the change involves and how the service needs to develop to meet the future demands its faces."

Comments on the NEAS proposals must be submitted by the end of August, which will be followed by a series of recommendations.

A discussion document is on-line at www.neambulance.nhs.uk. People who do not have access to the Internet and want more information can call 0191-226 4460