Proposals to close the A&E at Huddersfield Royal Infirmary and downgrade the hospital will be sent to the Health Secretary, Jeremy Hunt.
That was the decision of councillors at Huddersfield Town Hall, who voted on the future of the hospital earlier today.
Campaigners who are fighting to save HRI hospital turned out to lobby this morning's meeting.
The local health trust wants to shut the hospital, moving accident and emergency services to Halifax, and build a smaller facility in Huddersfield.
Campaigners were outraged last week after it emerged that the replacement hospital would have just 64 beds, not 120 as originally proposed.
But, Calderdale and Huddersfield NHS Foundation Trust says it faces significant quality, safety and financial challenges being split across two sites.
The council's scrutiny panel previously said it had concerns about the lack of detail in the plans.
Campaigners are calling for the resignation of bosses at both Calderdale CCG and Greater Huddersfield CCGs, after what they describe as 'repeated failings' to protect local services.
But Calderdale and Huddersfield NHS Foundation Trust say there is "rationale" behind the changes.