The Cupar minor injuries unit will close on July 17, despite a community campaign to save it.
All north east Fife minor injuries services will be based at St Andrews Community Hospital.
The move includes the x-ray service.
Health and social care chiefs say running two minor injuries units (MIU) amid staff shortages is no longer sustainable.
And while the move will save £140,000, they insist money-saving is not the main factor.
However, Cupar councillor Margaret Kennedy said: “I absolutely do not support this.”
Ms Kennedy is a member of the Integration Joint Board, which made the closure decision on Wednesday morning.
She said the proposal had caused public tensions and “a fair amount of angst”.
And she added: “It beggars belief we have got to this position.”
Fears over transport and 1,500 new houses
Ms Kennedy claimed the staffing problems were foreseeable.
And while she welcomed an announcement of future investment for Adamson Hospital, it did not quell her concerns.
The Lib Dem councillor said the decision “flies in the face” of previous assurances over the hospital’s future as a diagnostic centre.
“Because of that, there is a distinct lack of confidence locally, particularly in light of the large deficits within the health and social care partnership and NHS Fife,” she added.
Community concerns also include the impact on health services of the huge Cupar North planning application, which could bring 1,500 new houses to the town.
And fears over public transport were also raised, with buses taking up to an hour to reach the St Andrews hospital.
Disappointment and claims of a ‘done deal’
Fellow Cupar councillor John Caffrey fears the minor injuries unit closure was a done deal long before the item reached Wednesday’s meeting.
However, his last-ditch attempts to remove it from the agenda to allow for further investigations failed.
North East Fife MSP Willie Rennie said the proposal had caused ‘deep anxiety’ in Cupar.
“This decision is deeply disappointing and one I remain opposed to,” he said.
Mr Rennie has now pledged to work to ensure the promises made about the Adamson’s future are kept.
Minor injuries unit ‘not the place for a heart attack’
Despite the fears, NHS Fife medical director Chris McKenna said moving to a single MIU at St Andrews is the right thing to do.
“The data suggests it would be better value and a better use of resource to have it sited at one hospital,” he said.
But the community consultation process highlighted several issues which will now be addressed.
As a result, services for frail elderly people will be enhanced at Adamson Hospital.
Meanwhile, a communications plan will be drawn up to inform the public what a minor injury actually is.
“A minor injury unit is there to deal with cuts and sprains and that kind of thing,” Dr McKenna said.
“It’s not the right place to be if you are having a heart attack.”
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