Emergency surgery is set to be moved from a busy Birmingham hospital to its sister site five miles away in the Black Country as part of a reconfiguration exercise.
But yesterday health watchdogs feared this was the trust's way of downgrading City Hospital's A&E department "by the backdoor".
Sandwell and West Birmingham Hospitals NHS Trust, which runs City and Sandwell hospitals, announced its plans yesterday at a joint meeting of Sandwell and Birmingham health scrutiny committees.
The move would see surgeons at City Hospital carrying out mainly elective operations, while emergency surgery would be moved to Sandwell General Hospital, in West Bromwich.
Coun Deirdre Alden (Con, Edgbaston), chairman of the city council's health scrutiny committee, described the plan as being "absolutely ridiculous".
She said: "They are suggesting that most of emergency surgery should be moved to Sandwell, about five miles down the road, while most elective surgery remains at City Hospital.
"Although we've been told they're going to keep A&E, if that's not backed up by emergency surgery what you've really got is a minor injuries unit.
"Ambulances will be told not to go there but people will still see an A&E sign at City and assume they'll be treated whatever their injury or illness.
"So this proposal, in a city where we have a number of shootings and stabbings, that's absolutely ludicrous. This to me sounds as if they're trying to downgrade City's A&E through the back door."
The trust also presented an update on its new hospital plans, which would see one of the two existing centres close.
Coun Alden added: "When the new hospital is eventually built it will probably be just over the Sandwell-Birmingham border in Smethwick, but that's much nearer than West Bromwich where patients will have to go for emergency surgery if this plan goes ahead."