The Friarage hospital at Northallerton was set up as a casualty clearing station in a former workhouse building in 1939 in anticipation of the bombing of Teesside.
Originally consisting of eight wooden wards imported from Canada, it now provides 25
0 beds along with services to 120,000 residents of remote rural communities, and employs 1,000 staff, mainly local.
But patient watchdogs were warned yesterday that the hospital was small in NHS terms, which put it at a disadvantage with busy city hospitals in recruiting the junior doctors who were the backbone of the service.
Another problem is European limits on working hours which came into force for doctors last year, meaning up to seven would be needed to provide cover previously ensured by the equivalent of one-and-a-half doctors.
Yesterday's meeting of the county council committee for the scrutiny of health care was told that although a high level think tank was already looking at the hospital's future, no proposals had been drawn up on maintaining the service.
Committee chairman John Blackie said: "The increasing momentum of these issues seems to be putting storm clouds on the horizon of small hospitals like the Friarage and it's a sad, sad day."
The meeting heard that the Friarage had been cushioned from a national recruiting crisis by its dedicated team of consultants who were "all-rounders" willing to tackle a range of tasks.
But many of these staff are now approaching retirement and the new culture in the NHS was towards more and more specialisation.
Consultants' jobs were now going begging at the hospital and because the staff was relatively small the shortages had a much greater impact, said the director of planning at South Tees Hospitals NHS Trust, Jill Moulton.
She added: "We have a constant battle to keep staff in posts to keep the service going.
"With consultant staff the whole nature of the job is changing, more specialised in their training so we need more people to do the same job."
She added that NHS changes meant consultants had to be available more or less immediately to oversee procedures such as births. Although there were 1,300 deliveries a year at the Friarage it was not enough to make the jobs attractive.
The chief executive of Hambleton and Richmondshire Primary Care Trust, Simon Kirk, stressed they were committed to keeping as many services going at the hospital as possible but consideration such as the EU working hours restrictions would have an impact.
He continued: "One of the perverse effects of the growth of the NHS is that there are lots of jobs to choose from – so the problem is making one of the smallest hospitals in the region attractive to come to and persuading people to stay."
The Friarage was merged with the Middlesbrough-based South Tees Trust three years ago and Coun John Smith was concerned about the direction that events had taken since.
He said: "Things have changed beyond all recognition and this is the main concern."
