Kirkcaldy was left without an accident and emergency department overnight because there were not enough doctors to staff the unit at Victoria Hospital.
From 8pm on Monday to 8am on Tuesday emergency cases were to be taken to Queen Margaret Hospital in Dunfermline, with Victoria only able to deal with minor injuries.
NHS Fife had drawn up contingency measures of closing Victoria’s A & E overnight last year, in response to a shortage of junior doctors.
However, this had not been required until Monday.
It coincided with calls for NHS Fife to “come clean” on a possible crisis facing the region’s A & E cover, which is set for a shake-up once the new wing at Victoria is commissioned in early 2012.
The wing’s opening will see Queen Margaret’s A & E downgraded to a minor injuries unit and more serious emergency cases transferred to Kirkcaldy.
An NHS Fife spokeswoman said the closure was down to the European Working Time Directive, which restricts doctors’ working hours.
The contingency plans, which were first reported to the public meeting of NHS Fife’s operational divisional committee in November 2009, cover the period from 8pm to 8am.
The spokeswoman said, “During this period, A & E services are concentrated at Queen Margaret Hospital with a minor injuries service continuing at Victoria Hospital.
“Similarly, acute medical admissions overnight will also transfer to Queen Margaret Hospital.
“This pattern of services is the most appropriate because of the links to surgical services centralised at present at Queen Margaret Hospital.
“NHS Fife’s primary concern is to ensure that clinical services are being provided with safe levels of medical staffing.”
She added, “These factors have been well documented over the years and were among the reasons that the Right For Fife clinical strategy was developed in 2001-02.
“The implementation of the contingency plan will remain under review in the light of changes to the clinical staffing available.”
John Winton, a candidate in the Fife health board elections, expressed concern at Fife having only one A & E.
He said, “Hopefully nobody would come to any harm, but it only takes one case.”
Independent councillor Andrew Rodger, who called on NHS Fife to “come clean” on the pressures facing A & E services, said, “If they don’t get their act together with consultants they employ locums and that costs them an arm and a leg.
“And while you get an ambulance to take you to hospital, you may not get an ambulance to take you back.”