A government decision to remove acute services from a County Tyrone hospital may be challenged in the courts, the area's MP has said.
Campaigners in Tyrone have vowed to fight on
Pat Doherty said he was "very disappointed" that the Tyrone County Hospital would be losing its acute services in favour of the Erne Hospital in Enniskillen, County Fermanagh.
The announcement came from Stormont health minister Des Browne in a decision on the future of the province's main hospitals.
Speaking after Monday's announcement, Mr Doherty said the minister's statement was full of contradictions, adding that access to hospitals across the border should have been considered in the decision.
"He has entirely ignored the response from southern health minister Micheal Martin, having sought it in very specific terms. He acknowledged that he received it, but then ignored it.
"I think this is not the end of the fight. Taking a legal challenge is one of the things we will have to consider," said the Sinn Fein MP.
A spokesman for Omagh District Council said legal advice would be sought on whether to take action in the courts.
Other hospitals that will lose their acute services as part of the changes are Whiteabbey, Mid-Ulster, Magherafelt and Lagan Valley.
The temporary loss of acute services at South Tyrone hospital in Dungannon will also become permanent.
The Downe hospital in Downpatrick will lose its emergency surgery capabilities, but it will keep its 24-hour accident and emergency and coronary care.
Downpatrick is also set to get a new hospital building costing £34m.
The Department of Health has estimated that a new £100m hospital to the north of Enniskillen could open in about five to six years time.
The announcement also includes a series of new buildings at most acute hospital sites across Northern Ireland.
The changes are the £500m start of a capital investment programme in acute hospitals.
The largest such investment in Northern Ireland, it is set to amount to £1.2bn over the next 10 years.
Des Browne said the current profile of hospital services was no longer appropriate and too many acute hospitals were being sustained for the population.
"Modernising our hospitals system is not about centralisation or the belief that somehow bigger is best: it is about getting the best fit of services around the patient," he said.
Mr Browne was expected to announce his decision last month, but this was delayed after new information was presented by the health department for people to consider.
Stanley Millar, chief officer of the Western Health Council, said he hoped the conflict created by the Enniskillen decision could now be left behind.
Have life-saving services
24-hour accident and emergency
"There has been a lot of passion, but unfortunately the local populations in both Omagh and Enniskillen were brought into a head-to-head confrontation and that is one of the sad realities.
"Hopefully after today, the situation will move forward."
West Tyrone Ulster Unionist Assembly member Derek Hussey said he was bitterly disappointed at the decision to base acute services at Enniskillen.
SDLP West Tyrone assembly member Joe Byrne described it as a "deeply flawed decision".
Last year, the devolved government announced plans for a shake-up in how Northern Ireland's hospitals and health service should be run.
The then health minister, Bairbre de Brun, announced plans for nine acute hospitals across the province.
One of those, a new hospital, was proposed for north of Enniskillen in County Fermanagh.
A single regional authority, which would replace the four health boards and have responsibility for strategy and buying services, was also announced.
In 1996, Northern Ireland had 19 acute hospitals which had full accident and emergency units and the facilities to carry out life-saving surgery.
In the years since then, there have been a series of reports from the Department of Health and from the health boards, all recommending the number should be cut.