Councillor Jamie Chaffey said the news was a "major disappointment" to Gunnedah, which has endured famously poor health services for years.

"We've have had the commitment from the coalition government to build this hospital that fit the purpose for this community, and we would not lose any services. That's critical for this community," he said.

"We simply cannot afford to have a facility that is built that does not fit that fit-for-purpose needs for this community."

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In a meeting with Hunter New England Health staff on Tuesday night, Gunnedah council was told the new hospital would have just 30 beds, and no specific paediatric unit, he said.

There would be 19 beds in inpatients and maternity, six in day surgery and five in the emergency department, Cr Chaffey said.

The hospital currently has 48 beds, 18 of them not funded and used for overflow patients.

Gunnedah Community Roundtable member, Kate McGrath, said the local health district had developed the bed number based on flawed modelling.

Fewer locals turned to the hospital to treat health complaints during the town's doctor crisis, leading to historically low numbers of presentations, she said.

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"Our concern is that when they're essentially budgeting for low numbers to remain, it's then hard for us to take seriously this 'build it and they will' come kind of mentality that the services will improve," she said.

"Better improved services would result in an increased number of people using the services, so when they're not budgeting for an increased number of people, it kind of calls into question whether they actually believe that they're going to be able to deliver on improving workforce and improving service responses."

Secretary of the Gunnedah branch of the nurses union, Heather Franke, was resigned to the bed cuts, though she doesn't support them.

"It's all done now, it's done," she said.

"We would have liked to have stuck with the same amount of beds we had but that's not going to happen, so we just need to move on now and make the best of it. There's nothing we can do about it. It's locked in."

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She said paediatric care will still be provided in the hospital's combined maternity, inpatient ward.

A spokesperson for Hunter New England Health said there would be no downgrade of services or staff at the new hospital.

The project remains at the design stage, and HNEH regularly reviews bed numbers, she said.

Cr Chaffey said the new hospital facilities would be "state of the art", with most rooms containing only a single or at most two beds, rather than four as in the current facility. It will also add both renal dialysis and chemotherapy services.

Nonetheless, he said the community needs better.

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"We had a commitment from HNEH and local member that we would not lose any services ... we would only gain," he said.

"We can't accept that as a community, because this upgrade to our hospital is crucial for the further of our development. If we don't get this right, this will have a major impact on what the future of Gunnedah looks like."

The hospital was built in 1916.

Tamworth MP Kevin Anderson promised to spend $53 million for a total hospital rebuild in advance of the 2019 state election. It was funded in the 2021 budget. Construction is due to start before 2023.

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