WALES in the UK is reeling from an acute shortage of doctors. The province's largest NHS trust has warned that it may not be able to sustain some hospital services for lack of doctors.
It is facing a shortage of 62 doctors this summer. Senior consultants and clinical directors have warned that there will not be enough doctors to safely run services in all its hospitals unless recruitment improves dramatically.
The warning comes as emergency and complex brain surgery was temporarily transferred from Swansea to Cardiff on Monday because of a shortage of middle grade doctors.
The crisis has also affected paediatric services in Swansea - all inpatient wards will be centralised at Morriston Hospital by the end of the week.
The dire shortage of junior and middle grade doctors has been caused by UK-wide changes in the immigration rules and ongoing problems recruiting doctors to work in Wales, especially in rural areas.
It is feared that more hospitals could be forced to review services if the problems continue.
Doctors' leaders have called on the Welsh Assembly Government to take urgent action to address the recruitment problems, Madeleine Brindley reported for WalesOnline.
Hywel Dda NHS Trust said that the problems have been exacerbated by candidates accepting posts and then withdrawing at short notice.
Interviews will continue to be held over next few weeks but trusts officials have said that it is possible that the number of doctors available will reduce to "an unacceptably low number" from August onwards.
Dr Alan Axford, medical director of Hywel Dda NHS Trust, said: "Hywel Dda NHS Trust, like others across the UK, is facing serious problems in recruiting junior and middle-grade doctors.
"The trust is doing all that it can to mitigate the problem but we are also developing contingency plans to ensure that safe services can be provided, should this recruitment problem continue.
"This may mean that we need to change the way services are delivered. As our plans progress we will keep patients, the public, and our partners informed and we would like to reassure them that patient safety will be our primary concern."
The warning from Hywel Dda NHS Trust comes as the European Working Time Directive, which limits doctors to a 48-hour working week, is due to come into force on Saturday. It is understood that up to 9% of doctors will not comply with the legislation until 2012 after exemptions have been obtained.
John Jenkins, senior public affairs officer for the British Medical Association Cymru, said: "It has been very difficult to attract doctors to parts of Wales for a variety of reasons, including the fact that some are slightly reluctant to go outside Cardiff.
"The changes to immigration rules has also reduced the availability of middle grade doctors."
An Assembly Government spokeswoman said: "Changes in immigration rules have caused problems with recruitment across the UK and we are working with trusts to address these issues.
"Health Minister Edwina Hart has written to the Home Office to ask for a review of the rules in relation to doctors and Assembly Government officials have met with the UK Border Agency to clarify the rules.
"We have also worked with the Deanery and the BMA to highlight how attractive Wales is to live and work in an effort to encourage more doctors to work here.
"A junior doctor review group has been established to review recruitment, training schemes, rotas and working conditions to promote a positive image of working as a junior doctor in Wales."