"People have no idea, they know about maternity, they have heard that in the news but they have no idea that these other services are going," said MacTavish, a Niagara Falls physician.

She said along with obstetrics, pediatrics is going, too, which means there won't be any more children at the Greater Niagara General Hospital, except in the emergency department, and even then there won't be a pediatrician to back up the emergency doctor, MacTavish said.

Kids' surgeries, encompassing broken bones, ear, nose, throat, and tonsil surgery will all be going to the St. Catharines hospital.

If you have ever had a child with croup in the middle of the night who can't breathe, said MacTavish, that is an emergency, but unfortunately for the parents living in Port Colborne or Fort Erie, they will have to drive much further to get medical care.

Urology, she said, most people would not appreciate, but an older man whose prostate blocks off his bladder so he can't urinate, which happens all of a sudden, would have to go to Welland.

"That's an emergency for them," Mac Tavish said.

Psychiatry will be moving to St. Catharines, which makes it difficult for those patients to receive care because a lot of those patients don't have the ability to get to another city because they don't have transportation, MacTavish said.

"A lot of those patients just have trouble driving," she said.

Ophthalmology is being lost to Welland, which affects people with cataracts who need the surgery done. Usually these patients are old, MacTavish said and they can't see, which is why they need the surgery done, and having to drive to Welland will be difficult.

She added that many ophthalmologists have expressed concern over moving too, and have considered retiring or opening up their own clinics.

The Greater Niagara General Hospital would be the centre for broken bones, but will accommodate only adults.

Adults and children orthopedic services will be in St. Catharines, which actually makes that hospital the "centre for excellence" in orthopedics, MacTavish said.

"So they told us, to make it look good, Niagara would be a centre of excellence for orthopedics, but really all they mean is these are the services they are not taking away completely," MacTavish said, "So it's just double speak."

The family doctor, who has been practicing in Niagara Falls for 17 years, said there are even broader implications of centralizing services to St. Catharines that go beyond transportation.

She said often people don't go to the doctor with one thing wrong with them, or if they do then sooner they will have another thing wrong with them, too.

Which she said spreads infection, citing the SARS incident where the spread of the infection was traced to people being transported to a different hospital.

MacTavish said she is objecting to removing the seven services from the general hospital to a new site because their hospital would no longer be a general hospital with all services.

"As a family doctor I'm involved in all areas of the hospital and that's why I'm upset about this plan because it's removing all those core services," she said.

She said she sees her patients every day for surgery, delivery, psychiatry, and pediatrics, something she calls continuity of care, and for her to travel between three hospitals regularly is poor use of her manpower, or for any other family doctors who wants to be involved.