ON the face of it the Government's stated health policy is to provide local services to local people but the financial constraints hospital bosses have to operate under often mean something very different.

The cheaper option of putting all services under one roof, regardless of the distance patients have to travel, is often the preferred one.

As the experience of the Wharfedale hospitals has shown, people often end up in a bitter, and sometimes futile, struggle to keep services local.

After a lifetime of protecting thousands of sick people, surviving two world wars and five monarchs you might expect to receive a pat on the back. But not Ilkley's Coronation Hospital - the 97-year-old building has been given the red card and is now threatened with closure.

Labelled by one GP as the 'People's Hospital', because it was built by the people for the people, the threat to it has increased as the population has risen.

In the past 15 years it has been scrutinised and had different threats made to its existence, but the residents are still firmly standing by it. Opened by Professor Chiene of Edinburgh University in April 1905 and built at a cost of £2,370, the hospital has revolutionised medical care in the area.

Before the creation of Coronation Hospital, Ilkley had three other hospitals, the Wharfedale Convalescent Home, Westwood Drive, the Ilkley Hospital, near the Grove, and the Cottage Hospital, at Sandy Dale, none of which function as hospitals today.

The Coronation Hospital was built in 1905 to commemorate the coronation of King Edward VII, it had nine beds, an operating theatre and an out-patient department.

Its first patient was Thomas Holmes, of Addingham, who had broken his leg whilst working on the building of the Star Hotel.

Over the years the hospital was expanded, seeing the creation of an x-ray department, more beds and in 1968 a physiotherapy department.

In 1985 the hospital was put under examination and a crushing functional suitability survey was carried out.

The conclusions of the survey were the catalyst for the hospital losing its in-patient status after a bitter battle in 1991.

It had been concluded that the operating theatre was not suitable, there was a shortage of space on the hospital wards and in the out-patients department, and it needed two extra examination rooms.

The axe was dropped on the hospital's 28-bed in-patient department after the study claimed its closure would provide upgraded facilities for out-patient, physiotherapy, x-ray, and occupational therapy services.

Described as Ilkley's biggest campaign, the doctors, the councillors and the residents united to defend their hospital.

The Coronation Hospital Campaign '89 was created and the town rallied together to take on Airedale Health Authority.

From the announcement in 1989 to the closing of the curtains in 1991 the residents battled vigorously to save the in-patient unit.

The reason given for the closure of the unit was that the same service would be undertaken more efficiently at Airedale General Hospital. Though the Airedale Health Authority had experienced an overspend of £500,000 in 1990 to 1991 it confirmed that as a result it would be in a better position.

In 1990 an Action Committee was set up to fight cuts at the hospital. It compiled a 30-page document detailing why the hospital should retain all of its services and residents submitted an 8,100-name petition.

However, in 1991 it was closed and the former female ward was transformed into the physiotherapy department, with a gymnasium created, treatment rooms for classes, ante-natal education, keep fit and recreational activities, stroke treatment and assessments.

Now in 2002 the hospital faces an even bigger battle for its very survival after the Airedale NHS Trust announced plans proposing the hospital's closure.

It maybe 13 years since the community fought to keep the in-patient department but following the announcement in the Gazette people are beginning to speak out against the proposals.

Councillor Anne Hawkesworth has confirmed that she will be organising a 2002 campaign to save the Coronation Hospital. Her feelings have been mirrored by Ilkley parish councillors, Ilkley MP Ann Cryer and local GPs, who have shown unfaltering loyalty to the hospital. The Ilkley Gazette is fully behind the campaign, too.

Chairman of Ilkley Parish Council, Mike Gibbons said: "Potentially, the vast majority of services, ranging from minor injuries treatment to X-rays and physiotherapy, could be lost to the town - I think that is something we must fight extremely hard to stop happening."

Even the report which sealed the fate of the in-patient unit in 1991 said it should be kept.

The conclusions of the Yorkshire Regional Health Authority report read: "The Coronation Hospital serves the community of Ilkley and is a resource which should be retained."

Once again the closure of the hospital would help resolve financial difficulties being experienced by the hospital's governing body. Hospital chiefs are hoping the move will help them to clear the trust's £1.6million deficit.

Chief Executive of Airedale NHS Trust Bob Allen told the Gazette that in order to balance its books they were proposing to curtail the services at Coronation Hospital. The trust is looking at alternative places to provide the services and intends to consider the Springs Medical Centre next door.

The hospital, which is part of the Airedale NHS Trust, provides a wide range of services to the people of Ilkley. These include physiotherapy, occupational therapy, chiropody, family planning, a young persons' clinic and the treatment of minor injuries.

The loss of the hospital would mean patients from Ilkley, Addingham and Burley-in-Wharfedale would face travelling to Airedale General Hospital.

From Ilkley it is eight miles to Airedale and takes 25 minutes by car, but for residents relying on public transport there is no door to door bus service.

Objectors feel it will put a greater strain on the elderly, in an area which has one of the highest percentages of elderly residents in the Bradford district. Dr R G Rawling, of the Springs Medical Centre, Ilkley, said: "It is not easy to get to Airedale General Hospital, the transport services in Ilkley are almost non-existent and then patients have long waits and little service.

"It is important to have hospitals where patients actually are, particularly for the elderly who rely on other people to take them to hospital. The hospital was put there by the people of Ilkley and its purpose is still there for the local population and it should continue to be maintain."

The Coronation Hospital has even had a recent revamp seeing its 30-year-old x-ray equipment replaced with new technology. The hospital was signed up to a 15-year contract in 2001 to rent new equipment from private company, Siemens.

In a report on the issue, Mr Allen, said that the preferred option for hospital management was to continue to provide X-ray services at local centres, including Ilkley, as well as at the main hospital site. The future of Coronation Hospital is unsure as the announcement by the trust is only the first step and it will be a long process before anything else is finalised.

But with a campaign to rival that of 1989, the trust can be sure that it will have a big fight on its hands.

Campaigners might take heart from what has happened in neighbouring Otley. For more than 20 years, the future of Wharfedale General Hospital has been under threat. Once a general hospital, with operating theatres and a maternity wing, the hospital is now much reduced in scale, but is still a vital resource for the town and the surrounding area.

Over the years as wards have been closed down and services moved to one of the Leeds hospitals. Many councillors and the area's MPs have fought for it to remain open. And now, the future of the hospital looks assured as work on its replacement gets under way at the end of this month.

The first hospital to be built by Leeds Teaching Hospitals NHS Trust under the Private Finance Initiative (PFI), the new £15 million hospital will be built next to the current hospital in Newall Carr Road.

The trust says the 'locality' hospital will provide a benchmark for community hospitals and will be a health facility to be proud of. And with the emergence of the new Primary Care Trusts - possible eventual managers of the hospital - services available at the new hospital could be expanded.

People in Otley feel very strongly about their hospital and it is perhaps due to their determination that the hospital has never closed - or moved out of the town. Now the residents of Ilkley face the same battle.

l A petition to save the Coronation Hospital has been launched and copies are available in the Ilkley Gazette offices in Wells Road for people to call in and sign.