The board has warned that services may collapse without change

The NHS board plans to develop the Royal Alexandra Hospital in Paisley as the area's main acute hospital.

Two mental health hospitals and two cottage hospitals face closure.

Inverclyde Royal and Vale of Leven would lose most of their inpatient beds under the plans but do more day surgery and outpatient appointments.

Consultation on the proposals will be carried out over the next three months.

Service collapse

The NHS board spends �40m more than it receives from the Scottish Executive each year.

In the consultation paper, it warned that some services would collapse if changes were not made.

This could lead to restricted availability or extended waiting times and may exacerbate staff shortages.

Argyll and Clyde is the latest Scottish health board forced to consider radical change.

Services will be reduced at Vale of Leven Hospital

Most medical staff will be receiving a pay rise this year, while new rules over working hours means Argyll and Clyde would need an extra 81 doctors simply to run existing rotas.

Even if the board had the money it would be impossible to recruit such a number of qualified staff.

However, it believes it has come up with a plan to respond to the need for change while providing "safe and sustainable" services.

Under the proposals two mental health hospitals - Ravenscraig in Greenock and Argyll and Bute in Lochgilphead - would close.

"Services will be transferred into the community and other locations, as appropriate," said the consultation paper.

Accident and emergency

The Victoria Infirmary in Helensburgh and the Dumbarton Joint Hospital are also earmarked for closure, with services being moved into the community or to Vale of Leven Hospital.

Proposals to reduce the services available at Inverclyde Royal and Vale of Leven would leave Royal Alexandra as the area's main accident and emergency department.

It would also be the only hospital able to carry out complex surgery.

The board has already decided to centralise maternity services at the Paisley hospital, sparking anger from campaigners in Inverclyde.

We need to provide services, not retain buildings Wilma Campbell Board member

They opposed the move to downgrade the service at Inverclyde Royal's Rankin Unit, which had a full consultant-led service.

The board decided instead to create new community maternity units, staffed by midwives, at Inverclyde Royal and the Vale of Leven Hospital in Alexandria.

The board said the new maternity services would continue under its latest proposals, while renal dialysis services at Inverclyde Royal and Vale of Leven would also be unaffected.

The proposals were outlined at a special board meeting on Wednesday.

Board member Eleanor Robertson, the divisional chair for Inverclyde, said it was "essential" that the area retained some medical beds.