Doctors leaders have announced a three-month public engagement exercise to discuss the future of Friarage Hospital services.
From March discussions will be held about children’s and maternity services at the Northallerton Hospital, ahead of a formal public consultation.
More than 1,250 babies were born in 2010-11 at the Friarage Hospital in Northallerton, making it the smallest maternity unit in the country.
But leading specialists are warning it is unsustainable to maintain full paediatric services at the hospital which will have a knock-on impact on maternity care.
One option could mean in-patient care for sick youngsters being transferred to the James Cook Hospital in Middlesbrough.
A midwife-led unit for low risk births could be set up at the Northallerton hospital but this would deal with a maximum of 500 low-risk births a year, leaving the majority of women to travel to Middlesbrough, Harrogate, York or Darlington to give birth - although uncertainty remains over the future of Darlington’s services.
This would mean some women in the Dales facing 40-mile journeys of at least 90 minutes to give birth.
Foreign Secretary and Richmond MP William Hague said: “The desire to increase specialisation in paediatric services must be set against the dangers and inconvenience to patients of having to travel even longer distances if these services are not retained.
“Every possible way of maintaining these services should therefore be discussed.”
A report by the Department of Health’s National Clinical Advisory Team (NCAT) found inpatient paediatric services were “unsustainable” due to difficulties “maintaining a workforce with the right skills, affordability and potentially clinical safety”.
The report said it was vital health chiefs were “completely transparent” in reconfiguring services.
“At the moment the public’s sense is that the big hospital is swallowing the smaller hospital and it would be unacceptable then to see the Friarage Hospital progressively closed because of death by many cuts’,” it said.
Local GP Vicky Pleydell, of the Hambleton, Richmondshire and Whitby Clinical Commissioning Group who commissioned the report, said doctors were committed to making the Friarage a “vibrant and sustainable hospital”.
She said: “I must stress that this is not about saving money but more about using the available money to invest in good quality services.”
Jill Moulton, director of planning at the South Tees NHS trust, said paediatric services at the Friarage had “felt very fragile for a long time.”