Emergency services have been scaled down at Prince Philip

Managers at Prince Philip hospital in Llanelli announced the move in August, saying that desperate attempts to recruit doctors had failed.

From 2000 BST on Monday, some out-of-hours admissions were transferred to nearby hospitals to be dealt with.

Protesters fighting the plans held a candlelit vigil at the hospital last Thursday night, but have not managed to stop the night-time closures.

They fear that lives could be lost if patients have to travel for treatment at hospitals in Swansea or Carmarthen.

Carmarthenshire NHS Trust, which runs the hospital, said the casualty service change was temporary and it hoped to minimize the effect on patients.

It is a bit like the people of Cardiff having their A&E services in Port Talbot Paul Harris, action committee

It stressed that most 999 emergencies admissions will continue to be brought to the hospital on a 24-hour basis.

Paul Harris, secretary of the action committee striving to keep the unit open, said he did not think the trust was listening to their protests, which include a petition signed by 10,000 people.

"I would say 98% of people in Llanelli are very angry at the trust," he said.

He said the committee, which is holding a public meeting on Tuesday night, was considering starting legal action against the trust over the closure.

"It is a bit like the people of Cardiff having their A&E services in Port Talbot," he added.

"We are concerned people are going to lose their lives on the way."

Protesters held a candlelit vigil against the plans on Thursday night

Prince Philip has already lost maternity, eye surgery and paediatric services.

In a statement, the trust board said it had "no option" but to temporarily restrict the accident and emergency service.

It continued that it had tried to fill the five vacant posts, but the continued use of locum, or hired, doctors could not carry on.

"Despite our best efforts, the department's middle-grade establishment is currently staffed entirely by locum staff and we have struggled for some time to keep the department open on a day-to-day basis.

"This is regarded by our senior clinical staff to be unsafe and unsustainable.

"We are determined to provide an appropriate 24-hour service at Prince Philip Hospital as soon as possible."

The trust said patients with any concerns should call NHS Direct on 0845 4647, who would advise whether they should attend an accident and emergency department.