Radical changes in maternity and children's services at Withybush Hospital have been recommended in a review unveiled last week.

They would mean the removal of consultant-led obstetrics, in-patient paediatrics and the Special Care Baby Unit services and their transfer to Glangwili Hospital, Carmarthen.

The review in mid and west Wales was carried out last year by representatives of three Royal Colleges - obstetricians and gynaecologists, midwives, and paediatrics and childcare.

Their conclusion was that the current service configuration in Pembroke-shire, Ceredigion, and Carmarthenshire is not sustainable in the long-term.

While maternity facilities at Haverfordwest were the best of the three units visited, there was no doubt major investment would be required whether there were changes or the present unit was retained.

The review recommended that Haverfordwest should provide a full midwifery-led maternity service with a birth centre.

It stated: "The midwives know that changes will come and are ready to face these changes/challenges."

Full antenatal care services would be retained at the Withybush site, except for the highest risk women. They would have to travel to Glangwili and the reviewers do raise concerns about the poor transport infrastructure and the impact on the ambulance service.

There would also need to be serious consideration given to the more vulnerable women in such areas as Pembroke Dock and Milford Haven, ensuring they have access to full antenatal services in their own locality as much as possible.

The review states: "Whatever decisions are made (including services remaining as they are or accepting our recommendations for change), there will need to be major investment in environment, infrastructure, and staff development. We do not consider that there will be any financial savings achieved."

Pembrokeshire and Derwen NHS Trust said: "Our aim will always be to see how best we can continue to provide and develop the highest quality maternity care for women and families in Pembrokeshire.

"No decisions have been made and any proposed changes will need to be considered as part of the wider debate on the future shape of acute services."