A retired surgeon has claimed ‘cost not safety’ is behind any centralisation of health services.

Peter Milewski, a well respected consultant general surgeon, specialising in colorectal surgery at Withybush Hospital, retired in 2010 after 21 years.

Mr Milewski has hit out at claims that centralising services will improve safety, saying there is no evidence to support this.

He highlighted a section of the Your Health Your Future document issued by the Hywel Dda health board and the wording of some questions on the recent ORS questionnaire it invited the public to fill in.

“There is no evidence that centralising improves care – the way statements are put makes you think ‘we are only a tiny place here so yes we do need to centralise’. It’s a sensible idea, but when you look at the evidence it’s not there,” he said.

Mr Milewski referred to three recent publications which included operation figures in its analysis, two UK based and one from America.

“The threshold to demonstrate those improvements is much lower than you would think – 20/30 a year in bowel and lower in orthopaedic.

“The evidence shows at Withybush we have easily got a high enough volume to maintain standards and there is no evidence that centralisation will improve quality. People need to understand that, simply because the statements make you think you need to do hundreds,” he added.

The National Joint Registry states that 220 knee procedures were carried out at Withybush Hospital and 191 hip procedures in 2011.

A Health Board spokesman said: “The opportunity for public comment on a number of potential solutions, which the Health Board has been openly discussing through its listening and engagement period, drew to a close on Monday, April 30th.

“The Health Board has been very clear that our services must meet safety and quality standards and we would not consider unsafe solutions. Absolutely no decisions have yet been made and any viable potential solutions identified will be considered ahead of any formal consultation later in the year.

“Any final service models proposed will need to improve both the quality of services and outcomes for patients.”

She added that the survey questions were developed by an independent social research organisation and were just one of many methods available to provide feedback to the health board.

“Each question had an open comment box which allowed responders to freely articulate their personal views on each of the themes raised within that question.

These comments will be considered as part of the survey feedback,” she said.