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28 September 2016, 19:05 | Updated: 28 September 2016, 19:09
The minority Scottish Government has suffered a parliamentary defeat after opposition parties united behind Labour calls to protect local NHS services.
MSPs backed by 64 votes to zero the party's motion urging Health Secretary Shona Robison to "call-in'' health board proposals for changes to hospital services.
There were 62 MSPs who abstained in that vote, after the Scottish Government's amendment stressing its commitment to "maintaining and improving safe and effective local services across Scotland'' was defeated.
After the vote, Labour called on Ms Robison to "accept the will of Parliament''.
Health spokesman Anas Sarwar said: "Parliament has clearly stated its will that the proposed NHS service changes and downgrades should be called in for ministerial decision.
"Will the Health Secretary take this opportunity to say she will accept the will of Parliament?''
Mr Sarwar had earlier argued the Government must designate plans to downgrade or close services in NHS Greater Glasgow and Clyde, NHS Lanarkshire and NHS Lothian as ''major service changes'', meaning they would require ministerial approval before they could go ahead.
"The bucks stops with Shona Robison and the Cabinet Secretary is accountable to this Parliament,'' he said.
"That is why it is vitally important that the Cabinet Secretary calls in the proposals so that all of us in this chamber who represent different communities and constituencies can ensure that all the various voices can be heard.
"It would be a democratic outrage if we allowed health boards to proceed with these decisions without individual members of this Parliament or indeed this minister having a say.''
"What is particularly frustrating for campaigners is that the Cabinet Secretary is saying nothing at all.
"If the Cabinet Secretary, as she said prior to the election, opposes any of these services changes, she should be brave enough to say she opposes them.''
Labour says maternity services at the Vale of Leven Hospital in Alexandria and Inverclyde Hospital in Greenock, paediatric services at the Royal Alexandra Hospital in Paisley and trauma orthopaedics at Monklands Hospital in Airdrie are all at risk.
It also has concerns over the future of inpatient services at the Centre for Integrated Care in Glasgow, cleft palate services at the Royal Hospital for Sick Children in Edinburgh and the closure of Glasgow's Lightburn Hospital.
Watched from the public gallery by local campaigners, Ms Robison said no final decisions have been made, adding that an established process is in place to determine if a particular service change is deemed major.
She said: "The possibility that some or indeed all of these service change proposals may change as a result of the public engagement under way, and that some or indeed all may ultimately be subject to ministerial approval, means it would be inappropriate for me to discuss the specifics in any detail today and say whether or not I support them.
"Where there are proposals for major service change in the NHS, they must be subject to formal public consultation and ultimately ministerial approval, and I don't shirk my responsibility whatsoever in doing that.
"Local people can be ensured that in all such cases, ministers take all the available information and representations into account before coming to a final decision.
"I think that is the proper and responsible way to run our health services.''
Conservative health spokesman Donald Cameron backed the Labour motion, saying there is "clearly a wider public interest at stake here''.
The Tory MSP said: ``It is our fundamental belief that given the public concern and controversy around these particular proposals, they should all be classified as major service changes so that the SNP Government takes responsibility for these decisions and can be held to account.''
Green MSP Ross Greer insisted the proposals left ``fundamental questions about access answered''.
He told MSPs: "I'm not sure that we're ready for changes to local services on this scale. We need to ensure that we have solid, well supported community services.
"We need to know that the clinical benefits for patients are proven, not just assumed, before pressing ahead with service changes. This demands robust discussion around future service delivery.''
Liberal Democrat health spokesman Alex Cole-Hamilton said later: "This vote sends a clear message to the Health Secretary that these damaging NHS closure proposals need to be called in by ministers and scrutinised by the Scottish Parliament.''