A Scottish health board this week gave the go-ahead to controversial proposals for service changes over which a trust chair dramatically quit.
Lord Ewing of Kirkford, a former Labour Scottish Office minister, launched a scathing attack on Fife health board's integrated healthcare strategy following his resignation as chair of Fife Healthcare trust.
He called the strategy 'an act of wanton vandalism on the NHS in Fife' that would lead to the loss of 760 beds and 1,400 jobs.
The row is particularly embarrassing because of Lord Ewing's political credentials. He was a Labour Scottish Office minister with responsibility for health from 1975 to 1979, and is highly respected in Scotland as a 'man of principle'.
In a statement issued last week, Lord Ewing said he was resigning so that he could continue to voice his 'strong opposition' publicly without damaging the trust.
'I want to make it abundantly clear that I am not against site rationalisation...
'But I am bitterly opposed to the wholesale closure proposals being suggested by Fife health board.'
Speaking to the Journal, Lord Ewing said: 'If these proposals had come out under a Tory government, there would have been marching in the street. The people who voted for them ought to know better.'
Vowing to fight on, he added: 'The staff will be campaigning against this. We are not prepared to allow 1,400 staff and 760 beds to be sacrificed on the altar of the balance sheet.'
The board rejected his claims and unanimously passed the strategy, which now goes out for public consultation.
Board chair Charlotte Stenhouse, said: 'I must take issue with Lord Ewing's claim that this consultation document is solely about hospital closures, cutting beds, and particularly putting hundreds of jobs at risk. It is not. The paper is about improving healthcare for Fifers for years to come.'
The integrated healthcare strategy calls for a greater role for primary healthcare. The amount of GP time purchased should increase by 10 per cent, with one practice nurse for every 4,000 people.
In the acute sector, there would be 'no future role' for Forth Park Hospital. Long-term, acute medical services will be consolidated on one site.
In mental health, Stratheden Hospital would close, to be replaced by community services. The strategy envisages fewer long-stay beds for older people, with the possible closure of Cameron Hospital. Lynebank Hospital for people with learning disabilities would also close.
Lord Ewing urged the board and Fife trusts to lobby the Scottish Office to extend the March deadline for producing integrated healthcare plans, so other options could be considered.
A Scottish Office spokesperson ruled this out, saying: 'It stems from the white paper, Designed to Care, which everyone else seems to think is a good idea.'
'It's not a question of the Scottish Office railroading things through. The health service has got to change but it's got to be done with everybody's co-operation.'