A century-old Murrurundi hospital is open to being demolished, after Upper Hunter Shire Council voted not to protect the historic building.
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Councillor Sue Abbott's motion to put an interim heritage order over the Murrurundi Wilson Memorial Hospital failed five votes to three, on Tuesday night.
The facility was built in 1919 to designs by famed architect George MacRae.
On Wednesday morning a devastated Cr Abbott resigned from the council's heritage committee, which she had previously chaired.
"I have questioned what is the point of a heritage committee on a council like ours," she said.
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Hunter New England Health argues the removal of the existing hospital building is necessary to enable access for ambulances to a new hospital built on the same site. Cr Abbott, among others, contests that claim.
A July attempt by the council to have the building heritage listed failed, but Cr Abbott said the refusal was due to what she said was an erroneous submission by HNEH.
Cr Abbott told Wednesday's extraordinary meeting that the community and council needed time for a second attempt to win heritage protection for the hospital.
But just three councillors voted to ban demolition work, with five voting against the motion.
"I'm just so disappointed that there appear to be closed minds last night at our council.
"I feel like I've let down the heritage committee and all of the Murrurundi community, and in fact the whole of the Upper Hunter shire community.
"The community have made it very clear that they want this building saved."
She said it's possible the building could win heritage protection after being turned into a pile of ashes.
Mayor Maurice Collison said the controversial debate doesn't have a "lot to do with the council".
"Council certainly tried [to preserve the building]," he said.
"Part of knocking the thing down was some of the parts of the old building had to be put back in front of the new building. Some of the brick work is going to be used again.
"You're never going to please everyone. They're certainly people up there that don't want it. There's certainly people up there that do want it demolished, that do want a nice new building."
Mr MacRae also worked on the Queen Victoria Building, the Sydney Town Hall, the Taronga Zoo Entrance among others.