PLANS to change the health care system in west Wales should be more ambitious and strive to create a better future for the region, a retired Pembrokeshire GP has said.

Dr Roger Burns, 68, a founding member of St Thomas Surgery, Haverfordwest, and a former board member of Hywel Dda has said the health authority’s transforming clinical services plans need to go further for a long-term sustainable future for the health service in west Wales.

New hospital locations

“It is illogical to have a new hospital outside of Pembrokeshire,” he said. “If you are going to build a new one it should be where the height of the population is in the summer.

“This is not only from the delivery of health care but also from the recruitment point of view.”

The health board, he said, prioritises giving the best care to the whole west Wales region over caring for the different counties of Carmarthenshire, Pembrokeshire and Ceredigion.


Withybush hospital.

Dr Burns believes health care in west Wales could be much more sustainable if Hywel Dda University Health Board and Abertawe Bro Morgannwg University Health Board were merged into one.

Dr Burns suggested the hospitals in Swansea, Llanelli and Carmarthen should be closed, with a new super-hospital built outside of the city on the M4.

A second super-hospital, he said, should be built along the A40 as it enters Pembrokeshire.

But he added: “The view of GPs in Pembrokeshire since this whole process started is that you cannot give the people of Pembrokeshire a good service until you have a dual carriageway running through the county.”

Under this new health authority, he said, the people of west Wales would have more choice of care within one area.

This would mean patients would not have to seek treatment in a different authority which diverts money away from their own hospitals, he said, citing patients who currently need to travel to Swansea for cancer treatment.

Recruiting new doctors

Dr Burns also shared his thoughts on the need to train more doctors and how to attract them to work in “periphery” areas like Pembrokeshire

He praised the current £20,000 grant being given to trainee GPs coming to Pembrokeshire to live and work, adding other incentives could be used to attract trainees to areas outside large cities.

“When I first came to Pembrokeshire there were 20 houses owned by the hospital trust. They could say to a consultant ‘We know you have been working as a registrar around the country and you haven’t been able to save a lot but we can offer you this house for £50 a month while you find a house’,” he said.

“That would be fantastic today.”

He also said trainee doctors could be spread further outside of large cities with medical schools like Swansea and Cardiff through taking advantage of digital technology for education, allowing people to learn as they train in hospitals in periphery regions.

“There is training opportunity at Withybush,” he said. “There is far more educational opportunity to be had and complex cases without all the back-up of specialists in the periphery than in city hospitals.”

But, the bottom line for Dr Burns is that more doctors need to be trained in the future.

“There’s not enough doctors for the next 10 to 15 years. We are going to be short of doctors,” he said, suggesting the UK could follow the model adopted by Germany of training a surplus of doctors, meaning positions in even the most isolated regions of the country are filled.

But the retired GP said the political momentum needed for a change like this does not exist because of short termism in the British political system.


There has been a series of demonstrations throughout 2018 about the future of health care in Pembrokeshire.

Hywel Dda’s transforming clinical services plan is due to see Withybush Hospital downgraded from a general hospital to a community hospital, alongside Glangwili hospital.

To replace the A&E lost with this change, a new hospital is planned between Narberth and St Clears.

Last month, the Withybush Medical Staff Committee wrote a letter to Steve Moore, the chief executive of Hywel Dda expressing its disappointment that plans for the future of health care in west Wales were not more ambitious.

Dr Burns writes for a blog which discusses the big issues facing the National Health Service in the 21st century. 

Read his work at