West Sussex primary care trust is heading for a battle with the county council over plans to close two accident and emergency departments.
The controversial plans are the result of 18 months' work on options for the county's healthcare - but were condemned by Conservative council leader Henry Smith as soon as they were revealed.
The PCT decided this week to start consultation on three options - all of which would see two A&E departments axed. The Princess Royal Hospital at Haywards Heath loses its accident and emergency department under all options and could be downgraded to a community hospital.
Either Worthing Hospital or St Richard's Hospital in Chichester would also lose a full A&E service, although as local general hospitals they would still provide some emergency services. Maternity and paediatric inpatients would be on one site, although a midwife-led maternity unit would be set up.
With only one A&E serving the county's population of 760,000, many people would have to travel outside the county for emergency services.
Mr Smith said: 'These are disastrous proposals which would hurt every community around the county. This is a bleak picture of the future for health services in West Sussex and the county council rejects it totally.'
The proposals have already been attacked by the area's Conservative MPs. Arundel and South Downs MP Nick Herbert attacked the limited options, saying: 'This is not a consultation - it is Hobson's choice.'
West Sussex PCT chief executive John Wilderspin said the proposed changes were intended to improve patient safety and quality of services.
'All the options have been developed jointly by doctors, patients and the public to ensure they are clinically safe and efficient. We are strongly committed to our local NHS and want to see it being improved in the future.'
Under the 'fit for the future' process, health services across Surrey and Sussex have been under scrutiny since early 2006 with the aim of bringing the NHS in the area into financial balance, moving services closer to the patient where appropriate and building sustainable acute services.