Northallerton Friarage Hospital maternity unit to lose consultants
Maternity and children's services are to be reduced at a North Yorkshire hospital.
The current level of provision at Northallerton's Friarage Hospital has been described as unaffordable and unsustainable.
The plans, first announced in 2011, have led to protests including a petition, and a march led by local Conservative MP William Hague,
The existing service, run by consultants, will become midwife-led.
The changes will start in October.
There will also be limited community paediatric services with no overnight stays for ill children.
Pregnant women or children with complicated medical conditions will have to use the James Cook University Hospital 22 miles (35km) away in Middlesbrough.
The Hambleton, Richmondshire and Whitby Clinical Commissioning Group (CCG) said the low number of births at the hospital meant it was difficult to provide enough doctors with the range of skills needed to cover more complex medical problems.
In the report announcing the decision, the CCG said it had "been unable to find a model that allows services to be delivered on the same footprint as before without continuing and unacceptable compromises on safety and sustainability, or unaffordable investment."
More than 10,000 people signed a petition opposing the plan and an appeal against the closure was made to the Health Secretary Jeremy Hunt.
In May, Mr Hunt rejected calls for a full review into the changes.
However the Foreign Secretary and MP for Richmond, William Hague, said he was "disappointed" at the decision.
"The Friarage is held in high regard and the uncertainty over the future of these services has caused a great deal of anxiety for patients and staff alike," he said.
He added: "It has been my view all along that while there are legitimate clinical concerns faced by the Friarage, these are challenges to be overcome and not surrendered to."
Dr Vicky Pleydell, chief clinical officer at the CCG, said: "We have investigated models of service up and down the country, leaving no stone unturned.
"Other options we looked at did not conform to the high standards we feel it is right to aspire to for our patients.
"Our job as a CCG is to ensure we deliver safe high quality services for our patients. We cannot compromise on that."