A growing group of residents are pushing to save the old Maitland Hospital site amid concerns the new one at Metford is not large enough to cater for the region's health needs over the next decade.
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An online petition has been started to collect signatures and a Facebook page has been devoted to the cause.
Save the Old Maitland Hospital organiser Amanda Playford said the High Street site should remain open as a working hospital and the new one at Metford needs to be used as an overflow.
She pointed to Maitland's population growth and the forecasted growth in the region as evidence of this need.
An extra 24,000 homes are expected to be built in the area by 2036, according to the state government's latest Hunter Regional Plan.
"I'm appalled like many others about this [closure]," Ms Playford said.
"The Maitland areas are growing rapidly ... With the amount of growth and development in the Maitland region we need to have [the old] Maitland hospital."
Former Cessnock councillor Rod Doherty, who now lives in Maitland, agrees the city has been shortchanged.
He has followed the project since it was announced in 2011 and said that while the new hospital had 339 beds, once you removed the day surgery beds and the renal dialysis chairs there were only 283.
That's only 87 beds more than the old hospital had.
Health Minister Brad Hazzard's office referred The Mercury's questions to Hunter New England Health (HNEH), who wasn't able to respond by the online deadline.
The Mercury then gave HNEH more time to comment and was issued with a page-long explanation the next day.
HNEH have confirmed it is working out how the High Street site will be used in the future in line with state government policy and "in consultation with local stakeholders including the Maitland City Council".
A spokeswoman said the new hospital had been planned on "the latest population health data" to make sure it met the needs of the Lower Hunter community now and in the future.
She also said the hospital was focused on providing some services outside of the health facility - and that was a focus the whole health system had, where appropriate.
"Contemporary models of care mean some services previously delivered in a hospital are now offered via alternate settings, such as Hospital in the Home. This means that some treatment spaces may no longer be required in the new Maitland Hospital into the future," she said.
"We constantly review our network to ensure we're providing appropriate healthcare services to the community."
Mr Doherty said it was well known the old hospital had been bursting at the seams for years due to a lack of beds and he questioned how an extra 87 would cater for health needs now and into the future.
He doesn't believe Maitland needs two public hospitals, but he is adamant it needs a 412 bed facility.
"We had 24 maternity suites at the old hospital and this new one will only have 20," he said.
"This new hospital was also supposed to have a Coronary Care Unit and there is none, so you have to go to John Hunter for that.
"Back in 2011 we were promised a 412 bed hospital with an over $700 million investment and that has been dumbed down to a $450 million hospital with just on 300 beds so it's not what the Hunter was originally promised.
"I believe that Maitland has been shortchanged and maybe Cessnock, Kurri Kurri and Branxton too."
The state government is yet to reveal how the High Street site will be used in the future.
Mr Doherty said it could attract a heritage listing and even become an aged care facility.
Ms Playford's mother worked at the hospital for many years and the history - and heritage significance - of the building also holds a special place in her heart.
"My mother lived, worked and trained there from the age of 17 until she was 70 plus. The stories she told us of the old ways and the bedside manner ... She nursed thousands of patients and looked after many ill and dying," she said.
The petition is available online at change.org and is called Let's save the Old Maitland Hospital.
The signatures will be passed onto NSW Health Minister Brad Hazzard.
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