Judge dismisses legal challenge over Hywel Dda's NHS shake-up plans
Campaigners against planned changes to hospital services in west Wales have lost three High Court judicial reviews into the legality of the shake-up.
Hywel Dda health board has said complex hospital births in Pembrokeshire are to be switched to Carmarthenshire.
Meanwhile, A&E services at Llanelli's Prince Philip Hospital will become led by GPs and nurses, prompting concerns.
But Mr Justice Hickinbottom said he was "wholly unconvinced" the health board's procedure was in any way unlawful.
The Welsh government said it was an "important day" for changes to NHS services in Wales.
Senior health board managers had referred the final decision to relocate Pembrokeshire's specialist baby care services to Health Minister Mark Drakeford.
The consultation process was challenged by campaign group Save Withybush Action Team (SWAT).
Campaign group Save Our Services Prince Philip Action Network (Sosppan) also challenged the way Hywel Dda had carried out a consultation on the Llanelli hospital changes.
In his ruling, the judge:
- refused permission to review the lawfulness of Hywel Dda's decision on changes to Prince Philip Hospital A&E services
- said all aspects of the procedures by both the health board and the minister on the A&E service changes were fair and lawful
- ruled the minister's decision process on neonatal services at Withybush Hospital was also fair and lawful
The judge said: "There is no doubting the sincerity of the claimants, and those who support them, in seeking to maintain the services at their local hospitals.
"They deeply believe that some of the changes proposed should not be made.
"The [health board] and the minister do not accept that premise. They say that the changes will result in better health services.
"This court is not concerned with the substance or merits of relevant decisions. The services to be provided to those who live in west Wales are a matter for the [health board] and the minister.
"It is they who have to grapple with the difficult decisions of providing health services to a population with increasing and competing demands for such services, in times of financial constraint.
"This court is only concerned with the lawfulness of the decisions, focused on the process adopted.
"On the basis of the submissions and evidence before me, I am wholly unconvinced that any aspect of the procedure adopted by the [health board] or the minister was unfair, or unlawful."
A Welsh government spokesperson said: "This is an important day - and an important judgement - for service reconfiguration in Wales.
"Health services need to evolve and modernise to meet the changing needs of the population and take full advantage of the benefits of new technology and advances in clinical skills.
"The court considered in detail the regulations and guidance underpinning the decision-making process for major service change in Wales.
"It found all aspects of the procedures adopted by both the health board and the health minister to be fair and lawful."
Health board corporate services director Chris Wright said he hoped the judgement provided staff, patients and the public with the assurance that its consultation over the planned changes was not only lawful but fully compliant with best practice.
"Our legal costs in defending the case are in the region of £300,000 - money that would have been better spent on front line services," he said.
"We are now eager to continue working with our clinicians to deliver a fit for purpose emergency service for Llanelli."