NHS Wales chief says health reforms needed for patient safety
The head of the NHS in Wales says patient safety could be compromised if hospital reforms aren't driven through.
In his first interview since becoming chief executive in June, David Sissling told BBC Wales the reforms would also take into account financial pressures.
But he stressed that safety was the greatest concern.
In the New Year every health board is expected to publish plans to change hospital services, and in some cases centralise treatment and close wards.
Hywel Dda Health Board in west Wales has already issued proposals which stress some services are already 'very fragile', and that they are having to spread 'scarce resources' thinly.
''I think at the moment our services are safe but they're under pressure," said Mr Sissling.
"If we do nothing the situation in two, three, four years might be one that we come to regret.
"We want to make sure we drive forward these changes in the light of quality and safety improvements."
Attempts to move and centralise care in 2006 stalled in the face of public objection, with several campaign groups rising to defend local hospitals against closure.
The Welsh government insists this time the need for change is more pressing.
"Safety could be compromised," Mr Sissling claims, "which is why now all our health boards are taking the trouble to set out those pressures to the local populations."
Earlier this week the Hywel Dda Health Board in west Wales became the first to set out potential changes to its emergency, cancer, surgical and maternity care across four main hospitals.
The options include downgrading the current Accident and Emergency unit at Llanelli's Prince Philip Hospital to an Urgent Care Centre.
"At the moment we are spreading ourselves thinly across four hospital sites,' says Dr Phil Kloer, director of clinical services for the board.
"The doctors and nurses work very carefully to mitigate any risks, but it's difficult across four hospital sites."
Dr Kloer insists the current service they provide is safe, but adds: "It would be much more sustainable and easier to sustain if we were able to focus a few services on particular sites."
But the Sosppan campaign group in Llanelli is unconvinced by the arguments put forward over safety.
Chairman Bryan Hitchman asked: "How on earth can a service become unsafe one day and yet be safe the day before?
"They have already made up their minds - it seems to all be done by stealth," he said.
"I think it's an attempt to make it unsafe so that it can be moved."
The group has fought against changes to care at Prince Philip Hospital in the past, arguing that a large, industrial town such as Llanelli needs a full range of services.
"Once again services are being eroded in this particular hospital," said Mr Hitchman.
"I think the people of Llanelli are being treated with contempt."
As head of the NHS in Wales, Mr Sissling accepts the concerns over safety are genuine, but points out that financial pressures are also part of the equation.
"To an extent money is something we take into account," he said.
"But I must say the service changes we're describing are predominately and ultimately driven by matters of quality and safety."
Proposals to change services in north Wales are also expected in the New Year, with pressure to consolidate some of the services currently offered across three main hospitals.
In south east Wales, changes could see more patients from Gwent and the valley areas having to travel to Cardiff for specialised treatment.