One community hospital in West Wiltshire is to close, while another is being massively downgraded.
A number of maternity units across Wiltshire could close
The West Wiltshire Primary Care Trust has a long history of overspending its budget and at a crisis meeting on Wednesday voted to take drastic action.
The trust needs to make £13.8m worth of savings by March 2006.
Westbury Hospital is to close most of its departments, leaving patients to travel further afield while Bradford-on-Avon is to close fully.
Carol Clarke, chief executive of the trust said: "We have to protect services into the future. No change here is not an option and we must go forward.
"Whilst we recognise people value their community buildings this proposal will ensure patients will be able to receive the same, or similar, range of services at either another community hospital, in their own home or in a suitable community setting."
Unison union representative Roger Davey said: "We are absolutely disgusted about this closure.
"Not just members, but staff and the local community are absolutely dismayed that the PCT is closing two valuable resources and two hospitals.
"More patients will be stuck at home looking for hospital beds or inappropriately-placed in residential homes or nursing homes."
Maternity services in the county are also under threat as the trust cuts its budget by 11%.
Additional beds will be provided at Warminster Hospital and its facilities used to support the transfer of services from Bradford-on-Avon and Westbury.