More than 300 people protested on Skye at the weekend over the planned closure of the accident and emergency unit at Portree Hospital.
Campaigners warned health chiefs that a dependence on Broadford Hospital, 24 miles away, was “ill thought-out” and would cost lives.
But last night a Scottish Government spokesman said while it was “understandable” the local community would want to retain maximum service provision, a “compelling case” for the move.
Sarah Marshall, chairwoman of the “SOS NHS Skye” campaign, attended the demonstration in Somerled Square.
She said: “We are aware that NHS Highland employees consider themselves at risk if they speak out or collaborate in any way with us, so there’s an atmosphere of real fear.”
A letter of gratitude from the campaigners was also handed in to the hospital.
It stated: “We want to thank all the staff who have been there for our communities and to recognise the services and care we have come to rely on and appreciate.
“We will strive to ensure that the lights will not go out and that the doors of Portree Hospital will be able to welcome those in need of care and support in an emergency.
“As we continue to campaign to save our services, we hope you will realise just what you mean to all of us.”
The campaigners want urgent talks with the health secretary and regional MSPs, calling for the case to retain A&E at Portree to be considered by an independent body.
They say the board has failed to provide “the rigorous scrutiny required for its proposals.”
NHS Highland chairman Garry Coutts said: “We understand the concerns that people have at the north end of Skye and we are determined to work through all of the clinical care issues before we proceed to make changes.”
Last night a Scottish Government spokesman said: “It is understandable that local communities will favour the maximum provision of services as close to their homes as possible.
“However, there is a compelling case that locating the new hospital in Broadford will allow a safer and more sustainable model of care to be provided.
“This was subject to wide ranging scrutiny, with considerable input from the people of Skye, during the consultation process.
“It is now important to move forward and ensure the plans put forward by NHS Highland provide the best possible services for the people of Skye. On that basis, the health secretary has asked NHS Highland to ensure that all local stakeholders continue to be kept fully informed and involved in the ongoing development and delivery of these services.”