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The department only opened six months ago
A London hospital trust which ran up debts of £150m should be divided up, a report will say next week.
Spiralling debts led to South London Healthcare Trust becoming the first NHS trust to be put into administration.
A government-appointed administrator will say on Monday its three hospitals should be hived off to nearby trusts and a Lewisham A&E unit should close.
BBC London's Karl Mercer said the plans could lead to "a radical shake-up" of care across the whole of south London.
Lewisham Hospital's A&E unit has been earmarked for closure in the report, six months after it reopened as part of a £12m refit.
The trust, unions and local MPs are not commenting on the report until it is officially announced on Monday.
South London Healthcare NHS Trust, which serves one million people in Bexley, Bromley and Greenwich, was put into administration in July.
The then Health Secretary Andrew Lansley appointed special administrator Matthew Kershaw after the trust ran up debts of £65m a year, which is about £1.3m a week.
Karl Mercer Political Correspondent BBC News
Wherever you look in London, the NHS is in flux. This is a service that has to save £5bn in the coming three years, and a service that is having to adapt to the changing needs of an ageing population.
Health chiefs say doing nothing is not an option, but the changes being proposed across the capital are controversial.
In north-west London a four-month consultation on closing four of the nine A&E departments in the area has just ended. The plans led to a series of demonstrations and a 60,000 signature petition against the changes. The NHS locally says the changes will be better for patients in the future - more care delivered out of hospital and closer to home.
Expect similar arguments in south London when administrator Matthew Kershaw announces his recommendations on Monday.
Local politicians have already indicated privately there will be a big campaign against such changes - plenty for the new Health Secretary Jeremy Hunt to consider when both the south and north-west London plans end up on his desk for a decision in February.
Three hospitals make up the trust; Queen Elizabeth in Woolwich, The Princess Royal in Orpington and Queen Mary's in Sidcup.
Mr Kershaw will recommend that the A&E unit at Lewisham Hospital closes and patients be moved to Queen Elizabeth's to save money.
The BBC correspondent said: "The trust has struggled to pay the bills for its new buildings which were built under the Private Finance Initiative (PFI). That's a kind of mortgage which has to be paid back over 30 years.
"Efforts to tackle the problems have so far failed which is why the administrator was brought in.
"His draft report out on Monday will lead to a radical shake-up of care across the whole of south London."
The Princess Royal is likely to be taken over by King's Health Partners in south London, Queen Mary's would be taken over by a mix of Dartford and Gravesham and Oxleas NHS trusts and the Queen Elizabeth is expected to join up with Lewisham Hospital.
The BBC correspondent said Mr Kershaw believes savings of up to £100m will have to be made in the next five years, with "huge" implications for jobs.
"He'll also say that the government should pay up to £20m a year to cover the PFI bill currently being paid by South London Healthcare Trust for its hospital buildings," he said.
Mr Kershaw's draft report announcement will be followed by a month-long consultation with staff, patients and the public.
A final report will be submitted to Health Secretary Jeremy Hunt in January 2013 for a final decision in February.
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