Nicola Sturgeon was told the NHS is at "breaking point" as she refused to answer Labour demands to give a "100% guarantee" to retain several local services.
Scottish Labour leader Kezia Dugdale called on the First Minister to promise the children's ward at St John's Hospital in Livingston will not be axed following a review.
Ms Dugdale also pressed the SNP leader at First Minister's Questions on the future of other local services, as she revealed that stress last year cost the health service 287,000 staff days, a rise of 21% on two years ago.
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The Labour leader, an MSP for the Lothian region, told Ms Sturgeon: "This really matters because it puts vital NHS services facing cuts under even more pressure.
"One of those services is the children's ward at St John's Hospital in Livingston, which is currently under review and potentially under threat of closure.
"The First Minister will tell us it is a decision for the health board, but she has over-ruled officials before and she should do so again now.
"My constituents would like a simple yes or no answer to this question - can the First Minister confirm once and for all she will not allow the children's ward at St John's to be either closed or downgraded?"
But Ms Sturgeon hit out at the Labour leader for "asking me to say now, before an independent review has concluded, that I will ignore any recommendations" to reduce services at the children's ward at St John's - which has previously been forced to close to inpatients as a result of staff shortages.
The First Minister, who previously served as health secretary, added: "The truth is that this is the Government that has protected St John's Hospital from the cuts that were planned to it by the last Labour administration.
"We will go on taking the decisions to protect St John's Hospital and hospitals right around our country."