TORONTO — A plan that may force patients to travel farther for some operations to save taxpayers money could result in reduced services and endanger the health of people in rural or northern communities, critics said Thursday.

Health Minister Deb Matthews said the province wasn't ruling anything out when it came to providing good value for health care. But she declined to provide specifics after a report that the Ontario government was considering radical hospital reforms that could save taxpayers as much as $3 billion a year.

It's a plan that would reportedly see hospitals forced to compete for cash by doing in-patient surgeries and treatments such as hip replacements more cheaply than rivals as they try to narrow their range of services and procedures to take advantage of economies of scale.

Progressive Conservative critic Elizabeth Witmer said such a plan would likely lead to more hospital and emergency closures and have a negative impact on health care overall.

"What you're going to see is that services are going to disappear from communities and I think people are going to have to probably drive quite a distance for care," Witmer said.

"With an aging population, that has its own share of problems."

When a similar plan was introduced in the United Kingdom about a decade ago, the changes led to a host of new administrative costs and brought in massive privatization of hospital services, said Natalie Mehra of the Ontario Health Coalition.

"This is not patient-centred care, this is the opposite of building accessible health care and it will force the specialization of local hospitals," Mehra said, adding that patients will be forced to travel long distances in a province that doesn't have the transportation system needed to support it.

"The distances are enormous in Ontario. It's never been done in a jurisdiction as big as this with the kind of population distribution that we have."

NDP Leader Andrea Horwath said the government should be up front about its health care plans and explain why this idea was favoured over others.

"We're very worried about what will happen to smaller community hospitals, to those rural hospitals, to those northern hospitals that already are facing significant cutbacks," Horwath said.

"We've seen emergency rooms already close, we've seen services scaled back at a number of these smaller hospitals."

Matthews said the province was committed to patient care, but said all options must be considered to help the province "get better value for money when it comes to health care."

"With things like hip, knee and cataract surgery, we've seen wait times come down because of innovations within the system," said Matthews.

"We cannot just continue to do what we've always done, which is just (invest) more money year after year."

While she wouldn't discuss specifics about the possible plan or the impact it could have in rural communities, Matthews insisted her goal remained to provide care close to home.

"We know people need health care as close to home as possible, but for some of the highly specialized services, sometimes people need to travel," she said.

"(But) if people need immediate surgery, then they will get immediate surgery as best as we can possibly deliver that."

Premier Dalton McGuinty has hinted at possible reforms in the upcoming budget, saying a broader conversation is needed about the future and reliability of health care to ensure services are available for an aging population.