THE bottom line about the threats to services at Prince Philip Hospital is the urgent need for Hywel Dda LHB to save around £40 million from its revenue budget. This reality is shrouded in clinical governance speak and tales of staff shortages, but the bottom line is the bottom line. No more bailouts from the Welsh Government — live within your means.

In any cutback situation there are options to discuss and evaluate. My disappointment is the total lack of imagination in the LHB proposals. There may be problems within the board's area with reactive and programmed work, why not make Llanelli hospital the acute hospital for Carmarthenshire?

The majority of acute cases come from Llanelli and district, industry is centralised here, we have the greatest needs in respect of health, deprivation and health inequalities, we could make Jeremy Williams, consultant in emergency medicine and unscheduled care, an honorary Turk. There would be fewer ambulance journeys and Glangwili could become an elective centre only.

Trouble is, I don't think the people of Carmarthen would approve of travelling 24 miles to access emergency care — strangely neither do the people of Llanelli who have fought for their hospital for generations.

After the 2003 night time restriction of A&E in Llanelli the Carmarthenshire NHS Trust didn't argue with our estimate of the number of dire emergencies arising in Llanelli and these patients will not survive a 24-mile journey. The phrase acceptable mortalities was uttered, but then no one on the board lives in Llanelli and is at risk of becoming an acceptable mortality.

Imagine the scene where your child is choking at 9pm in the evening and the panic shock and trauma that results? Don't worry, Carmarthen is not that far away — and who knows how long it will be before an ambulance turns up to take you there?

The clinical governance argument that we must provide a safe service is weighty but as a local health board you cannot abrogate your duty to provide health care to the public. Sorry you died but we couldn't provide a safe service. Services would quickly recede up the M4 (but they would be safe services). A safe service 50 miles away is not much use in a dire emergency.

Acute care must be close to centres of population and open 24 hours a day, seven days a week. This is the argument Edwina Hart used to try to keep emergency neurosurgery at Morriston, but she lost the fight. We have Llanelli women now travelling as far afield as Abergavenny and Cardiff to give birth. This just isn't acceptable and is an absolute scandal being accepted by the Hywel Dda LHB.

The Star is absolutely right in calling for improvements to services at PPH, this is the reason the Committee for the Improvement of Hospital Services chose their name.

Nye Bevan, when asked how long the NHS would survive, responded that it would last as long as there were people prepared to fight for it. I have faith in my fellow citizens that we will fight because to do otherwise is to let ourselves, our families and our neighbours down.

Paul Harries

Hilltop

Swiss Valley