Up to 20 maternity units in England face closure as NHS leader warns the current system is 'not fit for purpose'

Matthew Hopkins, the NHS Alliance's director for acute care, says centralising childbirth into fewer hospitals is 'inevitable' as doctor shortages grow and caesarean rates climb. Those living in rural and coastal communities may have to travel further to give birth.

Hopkins acknowledges the closures are likely to trigger a political backlash over unpopular changes.

The NHS Alliance warns 'difficult decisions' lie ahead for maternity services.