Protests have been held in Llanelli against the closure

Three senior doctors from Carmarthenshire NHS Trust justified their decision to county councillors by saying there had been "near-misses" involving patients in the accident and emergency unit at Prince Philip Hospital.

They also warn that a crisis in recruiting middle-grade doctors to west Wales could force changes and cuts at other hospitals in the region.

Since the start of the month the Prince Philip unit has closed between 2000 BST and 0800, with some patients sent to hospitals in Swansea and Carmarthen instead.

The trust says it is committed to reopening the department as soon as possible, but the doctors admitted that could be a long way off.

There have been some near-misses at Prince Philip A&E. I felt the service was neither safe or sustainable A&E consultant Jeremy Williams

The doctors, who advise the trust on medical and safety issues, revealed to councillors that before the unit closed it was being run entirely by temporary staff.

The five middle grade doctors' posts at Llanelli are all vacant.

Jeremy Williams, A&E consultant at West Wales General Hospital, Carmarthen, said: "This reflects a national problem with recruitment of staff grade doctors.

"We found ourselves in the situation that we were running entirely on locum doctors.

"There have been some near-misses at Prince Philip A&E. I felt the service was neither safe or sustainable."

Quick fix

Ben O'Donoghue, head of A&E in Carmarthenshire, said: "A number of senior clinicians began to express concerns about quality issues within the A&E department.

"A service run by locum doctors is potentially dangerous.

"There has been problems in recruiting surgeons, anaesthetists and intensive care doctors in west Wales.

"It's a significant problem in other hospitals across south west Wales.

"A quick fix is possibly not an immediate alternative."

Mr O'Donoghue said the A&E department at Baglan Hospital, Neath, was having to shut on an ad hoc basis because of staffing problems.

Councillors were told all other hospitals in the region were having recruitment problems.

Medical school

Trust medical director Peter Thomas said the problem was that doctors working in smaller hospitals in west Wales were on call one in every three or four days.

Those in larger hospitals in big cities were on call just one in every 10 or 12 days, making jobs there far more attractive.

Changes to encourage more doctors to become family practitioners introduced last year had also taken their toll.

Mr Thomas said one solution would be to extend the recently-opened Swansea medical school, set up to train more doctors, to benefit the whole of south west Wales.

"If the Swansea medical school became a west Wales medical school then we would have a much better chance of developing services across west Wales," he added.

"The benefits could be immediate and very large.