Anaesthetist cover at the Vale of Leven could be axed under the proposals
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Anaesthetist cover at the Vale of Leven Hospital in West Dunbartonshire is to be removed under plans approved by NHS Greater Glasgow and Clyde.
The health board said it would now submit its decision to Health Secretary Nicola Sturgeon.
The plans had been out to public consultation and were the subject of an independent review.
Dumbarton Labour MSP Jackie Baillie has accused the health board of failing to listen to local people's concerns.
NHS Greater Glasgow and Clyde originally wanted to close the unscheduled admissions unit at the Vale of Leven hospital in Alexandria.
But an independent review, ordered by the Scottish Government, said it should remain open.
The review concluded that anaesthetic services at the hospital were unsustainable, but suggested a compromise under which most patients could still be admitted and some emergencies would be transferred to Paisley or Glasgow.
On Tuesday, the health board "agreed to propose alternative arrangements for the provision of unscheduled medical care" at the Vale.
This, it said, would "ensure that 70% of current patient care could be maintained without the need for anaesthetic cover".
Future 'secured'
Health board chairman, Andrew Robertson, said he was delighted the future of the Vale of Leven had been secured.
"Although this model means that more patients in the most at risk categories will have to go direct to the Royal Alexandra Hospital in Paisley, we plan to significantly increase the overall level of activity on the Vale site and make sure that fewer patients have to go Paisley or Glasgow for their care.
"This change will affect a material number of people, some of whom travel regularly because of their long-term chronic illness."
Ms Baillie said the removal of services for "most at risk" patients would make it difficult for some people to access the proper care.
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The hospital will effectively be reduced to a weekday service for outpatients only
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She said a lack of adequate public transport offering a direct route across the Clyde meant that it could take more than two hours to travel from the Vale of Leven to the Royal Alexandra Hospital, by train or bus.
She has argued for a "north of the river" solution which would mean the reconfiguration of services at the Golden Jubilee in Clydebank or Gartnavel in the west of Glasgow.
Ms Baillie said: "NHS Greater Glasgow and Clyde have shown utter contempt for this community. I am furious that after months of consultation they have failed to listen to our concerns.
"It seems they have simply gone through the motions without listening to what was being said to them.
"Their proposals to remove services like anaesthetics, coronary care and stroke treatment mean the hospital will effectively be reduced to a weekday service for outpatients only."
The GMB Union has also voiced concerns about the downgrading of services.
Jim Moohan, senior organiser and chair of the community campaign group Hospitalwatch, said the removal of anaesthetist cover would place the population in an "extremely fragile position" and would reduce the facility "to no more than a cottage-type hospital".
He said: "The proposals, which are based mainly on a cost-cutting exercise to pay homage and give credibility to projects elsewhere, are totally unacceptable."
The Vale lost its accident and emergency unit and consultants in the maternity ward after previous reviews.
It was also at the centre of an outbreak of Clostridium difficile, when 18 people died and more than 50 were infected between December 2007 and June 2008.
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