Mr Lansley said the review was run by a joint committee of primary care trusts, and was independent of him and his Whitehall department.

"I don't know what their decision will be and they will have to make that decision then. From my point of view, after that technically that is the basis on which the commissioning will then go ahead. They'll decide what the transition looks like."

Depending on the outcome, the Health Secretary said he may have to make a judgement on the impact on nationally commissioned specialist children's heart services - covering some surgery done by local units. That could take two months.

"The other thing is whatever decisions they make, if it leads to a major service change the local authorities in the area can examine it.

"And if they decide they have any substantive objections, they can refer it to me and I have the power to look at it," added Mr Lansley.

If that happened, he said he would ask the independent reconfiguration panel to consider the objection - which could take two to three months - before it came back to him for a final decision.

The Health Secretary said: "I would prefer the decision that was made by the joint committee to be one that people felt was fair, justified, would provide benefit to patients. That is where they started from."

While the review was looking to reduce the number of surgical teams, Mr Lansley did not envisage the closure of affected units - suggesting they would continue to provide associated services, such as out patients support.

But he acknowledged children needing surgery might have to travel to a "more distant" unit.