NHS Fife have slammed the door shut on any prospect of A&E returning to Queen Margaret Hospital.
The board held their annual review on Monday with health chiefs asked about bringing the emergency department, which closed in 2012, back to Dunfermline.
With a rising population due to the thousands of new houses being built here and city status granted last year, the calls for its return have only grown louder.
But despite emergency admissions at the Victoria Hospital continuing to rise, Chris McKenna, medical director, said an A&E department in West Fife was simply not possible.
He said: “A&E departments are the front door of an acute hospital and supported by many other specialties.
"You can’t run an A&E without all of those support services around you because you won’t be able to safely look after patients.
“Decisions were taken a number of years ago to create a single acute hospital in Fife – which is the Victoria Hospital in Kirkcaldy.
"That’s where we have to deliver acute care.”
A petition with 20,000 signatures called for A&E to return but NHS Fife have remained resolute since the decision was taken.
Dr McKenna added: “While we aren’t able to provide an A&E department at Queen Margaret there are many things we can do, to ensure our urgent care services meet the needs of many people.”
The news didn't go down well with Dunfermline North councillor Gavin Ellis who is one of many to have campaigned for A&E - and other services - to return to QMH.
He said: "It’s not a surprise to see NHS Fife sticking to the mantra of we have to deliver acute care in Kirkcaldy.
"The issue here is the assumption that we as residents don’t understand the Queen Margaret would need all the back-up services required for an A&E and maternity.
"We know, what we don’t understand is why nothing has been done in the last decade."
Cllr Ellis concluded: "I have fought for years to try and get answers and I’m not stopping now, as residents we deserve the services afforded to other cities.
"I will be demanding more from the Scottish Government and NHS Fife on how they ensure West Fife gets the services we once had restored."
Cllr James Calder, convener of the City of Dunfermline area committee, said: “Unfortunately due to years of Scottish Government failure to support our NHS, we have seen more and more services taken away from the Queen Margaret.
"This is despite the fact that Dunfermline is a rapidly growing city.
"They must change course and provide the support necessary for NHS Fife to deliver services locally.
"With growing demands on the NHS, it is more vital than ever that people can access services in Dunfermline rather than the long trip to Kirkcaldy.
"Ideally this would include the return of services such as A&E and maternity, but realistically this could take a long period and in the meantime there are other services that can be brought back to Dunfermline.
"I am demanding the Scottish Government present an action plan to bring back more services back to the local community and make the Queen Margaret a fully functioning hospital again."
At the annual review, acting chairman Alistair Morris had described QMH as a “jewel in NHS Fife’s crown” and said the board will continue to “invest heavily” in its facilities in the coming years.
He highlighted the £2m project to increase surgical capacity in Dunfermline, and the new orthopaedic centre in Kirkcaldy, as positive steps but said they were also having to deal with financial pressures, long waiting times for treatment, increasing demands and staffing issues.
Cllr Ellis responded: "They may feel the Queen Margaret is the jewel in their crown and I will say that’s due to the fantastic staff, not the management teams.
"To us residents it feels like a slap in the face from the management."
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here