When changes are proposed to important services like hospitals, none of us can always expect to get our own preferred outcome.What we do have a right to expect is that decisions that are taken should be reasonable and justified by rational argument. Current proposals to reorganise specialist hospital services in Manchester fail this test.Wythenshawe Hospital has some top class specialisms that serve the North West and beyond.The hospital is our region’s transplant centre; the NW Lung Centre provides vital services for many – including people living with cystic fibrosis; cardiac services are renowned; there is an ‘ECMO’ facility for the most serious intensive care; Wythenshawe is a trauma centre on the doorstep of the busiest UK airport outside London – it even has a helipad to bring the most urgent cases straight to surgery.These complex ‘tertiary’ services are supported by the highest standard of general surgery, which can only be maintained with large numbers of acute patients coming to the hospital.Yet when ‘Healthier Together’ was choosing which teaching hospitals should be ‘specialist’, it found that Wythenshawe didn’t make the cut. If that decision was made on reasonable grounds, then we would have to accept it: but I don’t believe this.Why do I think the decision is indefensible? Firstly, an extensive public consultation favoured Wythenshawe. Public opinion should only be disregarded if there are overwhelming reasons. Here, the opposite was the case. When any of us is contemplating treatment our most important concern is the clinical outcomes at a hospital. Based on this, Wythenshawe was the obvious choice. Instead, the review concluded that because all the hospitals were being asked to meet higher standards in the future, the current standard of clinical performance was irrelevant!They then made a decision based wholly on travel time. Stepping Hill was chosen for shorter journeys for a small population in the High Peak, incredibly they reached this decision without reference to the new A6 relief road that will slash journey times from Derbyshire to Wythenshawe.It is against this background that consultants at Wythenshawe have decided reluctantly, to take legal action to overturn this decision.No-one wants this to be settled in court. It is time for the NHS to get a grip and reopen its review to allow a proper decision that has the confidence of doctors and public alike.