Proposals to axe beds at six cottage hospitals in North Cumbria have been criticised by the union Unison. The moves, affecting sites at Brampton, Keswick, Millom, Maryport, Cockermouth and Alston, have yet to be approved.
North Cumbria Primary Care Trusts said the public would be given their say on the shake-up.
The union Unison said it was concerned that services were becoming too centralised to meet the demands of more rural parts of the county.
A spokeswoman for the North Primary Care Trusts said the aim was to shift the balance of healthcare provision to being more community-based.
 |  "We will be calling on the primary care trusts to think again about the best way to deliver vital health services to the people of Cumbria. |
She said about �1.8m would be spent improving community nursing services, including out-of-hours provision.
She added that no decisions would be made until March when the public had been fully consulted.
But Liz Twist, Unison's regional head of health, said the union was "hugely concerned" at the idea.
She said: "Only last week talks between managers and staff won a temporary reprieve for Alston Hospital and now it is under threat once more.
"We will be calling on the primary care trusts to think again about the best way to deliver vital health services to the people of Cumbria."
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