The statement said the merger might reduce the hospitals' incentives to improve the quality of specialist services, which include rheumatology, rehabilitation, general medicine, general surgery, geriatric medicine, dermatology, clinical haematology, oral and maxillofacial surgery, cardiology and palliative medicine.
After the inquiry, it was recommended that paediatric cardiac units be set a target for the number of operations per year, and surgery be concentrated in a few specialist centres to ensure quality of care.
So in Wagner, South Dakota, patients can receive high-quality, lifesaving medical care from a Sioux Falls specialist who can monitor their EKG and listen to their breathing -- from 100 miles away.
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Four years ago, NHS Quality Improvement Scotland commissioned Dr Alastair Ross, a specialist in risk management at King's Health Partners' Simulation and Interactive Learning Centre, to look at the picture across Scotland.
The confederation asked a number of questions - you can read them all here - and concluded that overall, "while concerns remain over the centralisation of specialist services, people still overwhelmingly prioritise the quality of hospital care over the time it takes to get there".
The review looks at the option of providing "specialist centres for some services where this will improve quality".
Professor John Last, chief executive of Norwich University College of the Arts, said: "This is a very significant announcement which recognises that 'university' title has to be about quality and not merely size and corrects an anomaly for a specialist institution established in 1845".
It is completely understandable that parents are worried about their local services moving away, but these changes are important so specialist units can achieve and sustain the necessary excellence and quality.
Christie's specialist, Jean Marc Lunel, said the Archduke Joseph is prized because it boasts the highest quality of shape, colour and clarity that can be found in a diamond.
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