Health chiefs say they are to formally consider a plan for a new "super" hospital for Canterbury - which could mean the loss of A&E departments in Ashford and Margate.
The news that the option for a full A&E hospital on a site at Canterbury came after campaigners lobbied the health minister this week to look into the option.
It follows an offer by private developer Quinn Estates to meet a significant part of the cost and build the shell of a new hospital as part of a major planning proposal for the south of the city.
It says it would be in return for permission to build 2,000 homes on surrounding land.
A statement issued today by the various east Kent Clinical Commissioning Groups said: "This potential option is a new build connected to the current Kent and Canterbury Hospital, which would be a single major emergency centre for all of east Kent, with one 24/7 A&E and all specialist services at the same hospital - such as trauma, vascular and specialist heart services.
"It has been possible to consider and include this potential option because a private developer has offered to donate to the NHS land and the shell of a new hospital which it would build adjacent to the Kent and Canterbury Hospital, as part of a development to build 2,000 new homes.
"Subject to planning permission and capital funding, this provides the opportunity to fit out new hospital buildings and still use parts of the existing Kent and Canterbury Hospital.
"This would be less than half the cost of building a new single site hospital on green belt land, which was ruled out as a possible option because there is not enough national funding to pay for it and it would take too long to build."
Developer Mark Quinn said: "We've been working really hard over the last five months in terms of the level of detail of the proposal to satisfy due diligence.
"This is really good news for east Kent as it's the common sense location for one major hospital.
"It's a really exciting opportunity for us as a company to be involved in something that has so many positive benefits for the community."
However, health chiefs have also said they will consider as a second option a different re-organisation of the three east Kent hospitals.
This would see the William Harvey Hospital as a major emergency centre with a 24/7 A&E department and the centre for specialist services in east Kent.
The Queen Elizabeth the Queen Mother Hospital (QEQM) in Margate would be the second emergency hospital, with 24/7 A&E, and the Kent and Canterbury Hospital would be a 24/7 GP-led Urgent Treatment Centre.
One of the two emergency hospitals would also be the centre for highly specialist services in east Kent, such as trauma, vascular and specialist heart services.
East Kent Hospitals’ Medical Director, Dr Paul Stevens, said: "There have been huge medical advances over the last 30 years.
"We treat patients very differently now, with specialist teams looking after people with specific conditions such as kidney disease and heart conditions.
"This has led to much more effective treatment and people are living longer, with a better quality of life."
Reacting to the news, Faversham MP Helen Whately said: "Initially this sounds like good news as we have been fighting for this plan to be recognised.
"We have asked for this option, which is the best for east Kent and Canterbury constituents, to be considered and now it is.
"There is still a long road ahead and there will be significant implications for other hospitals which need to be looked at."
Canterbury and Whitstable MP Rosie Duffield said she was "delighted", but added: "It is important that any decision made doesn’t put any group of people in east Kent at further risk of harm, trauma or waits beyond NHS target times.
"Studies have consistently shown that Canterbury has the best demographic reach for any single hospital that were to be based in east Kent and a major hospital in our city could be a boon for the wider region.
"This proposal is obviously subject to planning permissions and relevant considerations; I hope that Canterbury City Council will work fast to see if such planning is possible, and obviously I would hope to see environmental concerns and social housing shortages acted upon as part of the planning process and any review of the local plan that may need to take place as a result of the commissioners' decision."
North Thanet MP Sir Roger Gale said: "First, it is entirely proper that all of the options should be on the table. Not to consider even those options that realistically are unaffordable and not acceptable would be a dereliction of duty and would lay the Trust open to the accusation that they were not open-minded.
"That said, the £800 million needed to build, equip and staff a new hospital with all of the supporting Estuary View style facilities that would be required is not available.
"Second, were there to be only one A&E hospital in east Kent, it would, because of the geography of the area and it’s transport links, need to be located where the major roads join at or near Whitfield and not in Canterbury!
"The realistic option is a rationalisation of the services at Thanet and Ashford and a modest rebuild of the K&C with a minor injuries unit."
Ashford MP Damian Green says residents in the town should fight against the plans to move A&E away from the William Harvey.
He said: "I am strongly against any proposals to move the A&E away from the William Harvey, and will argue the case as hard as possible through the consultation period.
"I would urge everyone in Ashford to join me in this."
The proposals are to be scrutinised and discussed at an open meeting at the Grand Hotel in Folkestone from 9am to 11am next Thursday.
To register interest to attend the meeting, email firstname.lastname@example.org.