Controversial plans that will change the provision of health services on Teesside have been approved.
County Durham and Tees Valley Strategic Health Authority announced the decision on Wednesday after a three-year review.
It means all high-risk pregnancies will take place at Hartlepool's University Hospital, moving some services from Stockton's Hospital of North Tees.
Stockton Council leader Bob Gibson described the shake-up in services as "flawed and unacceptable".
The announcement comes despite opposition to some of the proposals which led to street demonstrations.
The decision means detailed planning will now take place on proposals which include centralising planned orthopaedic services at the University Hospital of Hartlepool.
Emergency orthopaedics will be centralised at the University Hospital of North Tees.
David Flory, chief executive of the Strategic Health Authority, said: "No change was never an option because the current spread of services was not sustainable.
"We know how strongly people feel when any changes are proposed to the services provided at their local hospital.
"But a very thorough process of public consultation has taken place, involving more than 250 meetings with the public, local councils, representatives from community and voluntary organisations and with NHS staff."
'Specialist facilities'
But Mr Gibson said: "Neither I nor the 20,000 other people who signed the petition against the plan are prepared to lie down and accept it.
"Moving specialist facilities to Hartlepool is not the answer.
"Just four years ago, Prime Minister Tony Blair opened what has become a very highly-regarded maternity Centre of Excellence North Tees University Hospital, after millions of pounds was invested in providing specialist facilities.
"You cannot simply create a new centre of excellence - it takes people, expertise and a great deal of money to develop over time."