Bury North MP David Chaytor said he was pleased with the report, which would ensure that most local women could still have their babies in Bury.

He said the NHS needed to change and Fairfield, rather than being downgraded, had been given a strong assurance of its future. "I am deeply disappointed that Fairfield has not been selected as one of the eight hospitals to provide the full range of maternity services," he said.

"However, I am extremely pleased that the report recommends a midwife-led unit. This should mean that the vast majority of women with routine pregnancies should be able to have their babies in Bury."

Mr Chaytor said he wanted an urgent meeting with local and regional health bosses to discuss how the changes would be implemented. "People find change very difficult," he said.

"Public confidence has to be built up. The transition from existing arrangements to new ones is the key thing: you cannot suddenly shut down one unit and open a new one. There should be no change to existing services until the major expansion of community health care facilities is properly in place."

The Labour backbencher said that better ante-natal facilities and community midwifery would help many women to have their children at home. "I don't see this as a downgrading," he said. "The fundamental issue for the NHS is getting the appropriate level of medical care. The idea that every small local hospital can provide every kind of medical treatment is no longer sustainable.

"People don't expect to go to Fairfield for brain surgery or complex cancer treatment. Community health and primary care would be appropriate for most things, with more complex problems handled at a big specialist hospital." On the loss of the children's ward, Mr Chaytor said that occupancy rates were very low: the overwhelming number of youngsters brought in did not stay overnight, and the average stay for others was just one night.

The Royal College of Midwives has raised concerns about whether North Manchester Hospital will have the capacity to cope with the extra workload it will face once services close at Bury and Rochdale.

Local representative Sue Coates said: "The decisions have been based on access not on capacity. I'm worried that across Greater Manchester as a whole we just don't have enough midwives. I'm also worried that the plans for a midwife-led unit at Fairfield seem very vague. We have no problem in principle with switching from a consultant to a midwife-led unit but we need more definite details."

Councillor Yvonne Creswell, deputy leader of Bury Council, said she would be demanding assurances about the future of other services at Fairfield. "Naturally we are pleased that A&E remains at Fairfield. However, the decision to downgrade the maternity unit is devastating news for all those people who fought so hard to keep it open.

"This decision will deny thousands of Bury residents access to local maternity services and is nothing short of betrayal. Bury Council will fight on: the battle now is to save the future of Fairfield and it's a fight we must win. The downgrade of Fairfield's maternity unit is totally unacceptable."

However, health minister Ivan Lewis, MP for Bury South, said the changes would in effect guarantee the future of the hospital and predicted that they would be welcomed by the majority of his constituents.

He said that £37.5 million of investment over North Manchester, Bolton and Central Manchester hospitals would transform the quality of maternity and children's health services, as would new investment in community based paediatric services.

He said: "I accept some will be disappointed at the replacement of the consultant-led unit at Fairfield, but babies will continue to be born in Bury at the new midwife-led unit. This is a major advance on the original proposals which would have Bury without any maternity provision.

"I have always supported the need for change across Greater Manchester and agree with the expert doctors and nurses that, from a quality and safety point of view, the status quo is not acceptable. Whether living in Bury or Radcliffe, Prestwich or Whitefield, parents will have a choice between consultant-led, midwife-led or home birth in the knowledge they will receive a safe and high quality service.

"That is what is important to parents and grandparents at this most important time in their lives. With regard to the Tories in Bury, I hope they will now stop their whispering campaign which has gone on for years suggesting Fairfield is at risk. The retention of the accident and emergency department guarantees a bright future for the hospital."

Vic D'Albert, Lib Dem Parliamentary candidate for Bury South, said the decision was a "kick in the teeth" for local people and said lives could be put at risk.

"This is a devastating blow for the people of Bury who have fought so hard against this. Campaigners have done everything possible to save these services, it is an absolute disgrace that the people of Bury have been ignored. This is a shameful act by a Labour government obsessed with cutting NHS deficits when it should be ensuring proper funding for local services.

"In addition, the confirmed closure of Rochdale A&E and children's services will further decimate local services. Lives will be put at risk."