Dear Editor, - It is encouraging to see that consultants at Withybush Hospital have realised there is strength in numbers since there are many wider, long-standing problems arising from NHS reforms.

Bed shortages at Withybush are not new.

I doubt there is much slack left in the system, but reducing beds before finding workable solutions and being economical with the truth regarding numbers does not inspire confidence.

Senior managers in Wales are paid more than their counterparts in England. Like them they receive additional efficiency bonuses, usually 'manager speak' for reducing costs and services. Other senior officers and non-executive directors rarely if ever visit front line staff to see and hear for themselves of the difficulties.

Trust Board meetings with the public and community health council are heavily censored with main or controversial items restricted or held 'in camera'.

Withybush Hospital has a poor record for industrial relations, with cutbacks, low morale and perennial problems with recruitment and retention of staff.

I experienced animosity for informing local MPs of the substandard oncology services, the death of five patients awaiting radiotherapy, and insufficient radiological services leading to unacceptable delays in investigation of seriously ill patients.

Issues regarding patient dignity, including occasional mixed sex bays, being moved four times in 24 hours, and safety eg looking after more than 50 patients in ten different locations, were dismissed as trouble-making.

Only an independent wide-ranging inquiry, with fundamental changes in management structure and accountability will restore public confidence in the Trust.

David J. Jones Retired consultant physician Withybush Hospital