WHEN will the carnage stop? Barely a week goes by when Hywel Dda Health Authority make abject apologies for avoidable healthcare disasters without recognising or addressing the real underlying issues.

The reported cases merely represent the tip of the iceberg as I am aware and have personally experienced many other unacceptable poor and dangerous standards of care.

Your latest report (January 7) suggests that without post-mortem it could not be said if the delay in admitting the unfortunate man pulled from the Mill Pond changed the outcome.

This is quite irrelevant as resuscitation of people who may have hypothermia can be surprising successful but every minute counts.

Transfer to Glangwili or Swansea hospitals, even by air ambulance, would have been a poor substitute for urgent transfer to Withybush where an expert team experienced in dealing with hypothermia should have awaited his arrival.

This is what used to happen when local knowledge and experience streamlined transfer to Withybush and there were no concerns about frequent use of locums and GPs impacting acting on the service.

The enquiry into the Cleddau Bridge collapse (1970) concluded that some of the deaths might have been avoided if the workmen did not have to be transferred to Carmarthen.

This was an important finding and used by local consultants and Desmond Donnelly MP to get the proposed replacement of Withybush upgraded to a full District General hospital, which in early days was a respected, enjoyable and rewarding place to work.

The Welsh Ambulance Service has never achieved the high performance figures of the old Pembrokeshire one, which has made the situation far worse.

In November 2014, Mark Drakeford declared that he did not want to apologise again when the next figures were published.

The December figures were worse, even though there was no severe winter weather or influenza pandemic which would have had dire consequences in a service not fit for purpose.

Pembrokeshire now has the worst healthcare services in Wales and therefore in Great Britain.

People responsible have moved on and/or insulated themselves against legitimate criticism.

Inquires conducted by the Health Board and Welsh Ambulance Service into their own actions after ignoring many previous warnings of the consequences would be laughable if it were not so serious.

A judicial inquiry into the right of the Health Board to introduce changes in reconfiguration of health services in Pembrokeshire was rejected but only an urgent, thorough, strictly independent investigation into the disastrous consequences of these changes will improve the standards and restore a proper National Health Service to Pembrokeshire.

DR DAVID J JONES MB.

BCH.FRCP Retired Consultant Physician

Little Haven