Emergency surgery has switched to West Wales General

All such operations will move to West Wales General in Carmarthen on Friday.

Dr Gibbons ordered an inquiry into why the changes were being made and said he wanted the service to continue while the inquiry was conducted.

But Carmarthenshire NHS Trust said it had to press ahead with the move to protect patient safety.

Hospital campaigners have accused trust managers of "engineering" the situation by not replacing a retiring surgeon.

The trust has written to the ambulance service, GPs and other bodies informing them of the move announced at a trust board meeting last week.

It has defended its decision to press ahead with the change that was recommended by the Royal College of Surgeons two years ago.

Any response I was going to make could not happen until those representations were made to me Dr Brian Gibbons, health minister

Clinical director Martin Taube said: "I don't think we could have done any more over the past few years.

"We've had public meetings, we've had private meetings, we've had workshops the public has been invited to, we've talked to the councils both in Carmarthen and Llanelli.

"I think everything we've done is compatible entirely with government policy."

The trust said for the last four years emergency surgery had only been carried out from 9am to 5pm in Llanelli, and recently this had amounted to between one and five operations a day.

'Panic'

Dr Gibbons has been accused of "electioneering" ahead of May's assembly elections after this week ordering an inquiry into the move.

He told BBC Wales's Dragon's Eye programme he could understand this point of view, given the proximity of the elections, but had been constrained by the timetable of events.

He said: "The community health council in Carmarthenshire only made its decision (to back the change in surgery services) at the end of November.

"And the representations that came to me didn't come till certainly mid December, so any response I was going to make could not happen until those representations were made to me."

What the trust is doing is abiding by what has been done successfully in England Prof Ceri Phillips, health economist

On the same programme, the Labour MP for Llanelli, Nia Griffith, described the decision to stop emergency surgery as "disgraceful".

Sian Thomas, chair of Carmarthenshire Community Health Council, and also a Plaid Cymru councillor, said the discussion had been going on for three years and at the request of the assembly "to look at the whole system and have a surgical review".

"All we've done is obey Welsh Assembly dictats."

She said the community health council had written to Dr Gibbons about the decision last November.

The Conservatives' health spokesman, Jonathan Morgan, said Dr Gibbons' intervention was due to Llanelli being Labour's most marginal assembly seat, with a majority of 21 votes.

He said: "The (assembly) government set the general framework, so whatever the hospital did they did it within the framework set out by the assembly government."

Lib Dem health spokewoman Jenny Randerson said: "It defies belief that (Dr Gibbons' inquiry) isn't motivated by the panic that Labour are facing in terms of whether they are going to hang on in Llanelli."

'Positive benefit'

Campaigners against the surgery move have collected a 36,000-name petition against what they say is a downgrading of the hospital.

Professor Ceri Phillips, a health economist at the University of Wales, Swansea, said: "I think the term "downgrading" is an unfortunate one.

"What the trust is doing is abiding by what has been done successfully in England."

He said ending emergency surgery at the hospital would make it less likely for routine operations to be delayed or cancelled.

He said: "Those people waiting for treatment in Llanelli can see this as a positive benefit, because they know that when they're told they will be going in to hospital, the high probability is it that they will be in on that day, at that time."