Herefordshire people are being urged to speak out to retain a full ear, nose and throat service at Hereford County Hospital.

Failure to do so could be a step to its downgrading to cottage hospital status, it is claimed.

The concern is expressed by Hereford solicitor Sue Powell in a letter to the Hereford Times after news that several options are being considered for its future.

Hereford Hospitals Trust has described the present service as relatively small, facing significant challenges, particularly that of complying with the European Working Time Directive, which demands a strict limit on working hours.

This could be met by increasing consultant medical staff, but the trust says appointing another consultant was unlikely.

Together with Herefordshire Primary Care Trust it is considering several options, one of which could lead to a joint ENT service with another hospital, such as Worcester.

But Mrs Powell has written to both trusts about such a move.

It could mean Herefordians having to be rushed to Worcester in emergencies requiring consultant staff not in the Hereford hospital when and where they are needed, she said.

Mrs Powell, of Barton Road, Hereford, cited the case of her husband who developed the throat condition, quinsy, which can block the swallowing reflex and then, if not treated promptly, breathing.

His condition became critical but he was treated "out of hours" by a consultant on duty in Hereford.

"It takes only a little imagination to conceive of medical emergencies linked to ENT that might occur out of hours, apart from quinsy, making the second option second-rate for the people of Herefordshire, not forgetting the distance many already live from Hereford city," she added.

Hereford Hospitals Trust will be discussing options at a board meeting on March 29; the PCT will do the same on March 24.

This week, David Rose, chief executive of the hospital trust, said: "Our first priority is to provide a service that is safe and sustainable and we are looking at how ENT services can be developed to ensure they deliver for local people."