I AM aware of the heated debate on health services locally, and I appreciated the letter from Miss Howells on a complex issue. Wherever it is, the concentration of specialists in centres of excellence invariably means fewer complications and greater life expectancy for their patients, provided the transportation is adequate.

A utilitarian approach means that the greatest good for the greatest number has to be the objective of the Hywel Dda board.

Withybush Hospital serves a larger population than the other hospitals in Hywel Dda, especially if holidaymakers and the oil industry at Milford Haven are taken into account.

I have not heard any argument that persuades me that Carmarthen, which is only half an hour from Swansea, should be that centre of excellence.

If the centre of excellence was in Haverfordwest, then patients in Carmarthen would be in an interesting position… in theory they would be mid way between two hospital, but they would not be able to choose Swansea as the rules stand today.

Therefore, the solution is that, in order to have that choice, under current Welsh rules, we should combine Hywel Dda and Abertawe Bro Morgannwg University trusts.

This would save money, and give all residents of the new trust the best service possible...

DR ROGER BURNS

(Retired GP) By email