Image copyright JOHN LUCAS/GEOGRAPH/GOOGLE Image caption Operations were cancelled at (clockwise from top left): Withybush, Prince Philip, Bronglais, and Glangwili hospitals

Routine operations at four hospitals have been cancelled for the third consecutive day due to issues over winter pressures.

Hywel Dda health board confirmed planned surgery would be postponed in order to "maintain patient safety during periods of peak pressure".

Planned inpatient surgery is affected at Bronglais, Prince Philip, Glangwili and Withybush hospitals in west Wales.

The health board said it had contacted affected patients directly.

Health minister Vaughan Gething said the health board was to conduct a review of decisions leading up to the cancellation of routine operations.

"That doesn't mean to say that those decisions are wrong on the information available, but it is about wanting to learn in the here and now," he told assembly members during a Senedd debate.

He also said he believed the health board's leaders had been "doing the right thing" and praised staff for their "exceptional response" during an "exceptional period of time".

Day case procedures and outpatient appointments continued as normal on Wednesday.

In a statement earlier, the health board said: "Whilst the situation remains challenging, we are currently assessing our operating plans for the days ahead and, as per normal planning arrangements, these will be reviewed on a daily basis."

Deputy medical director Dr Sion James said the "hospitals are full" due to "a number of challenges" including a norovirus and flu outbreak.

"A number of operations are still taking place but some will be postponed after today, but everybody in the board is working as hard as they can to make sure the operations will happen as soon as possible and as safely as possible," he said.

Image caption The British Medical Association in Wales is meeting the Welsh Government to discuss winter pressures on Wednesday

Patient watchdog the Hywel Dda Community Health Council said it was "concerned and disappointed" about the cancellations.

"Patients and their families will have been waiting months for their operations and now their lives go on hold," said chairman Mansell Bennett.

Dr Phil Banfield, chairman of the British Medical Association (BMA) Welsh consultants committee, said: "There isn't one person to blame for this - this is an issue within the system.

"There are two factors here - there's the lost operations, people having elective surgery who may become worse and become emergencies as a result.

"We're hearing reports of cancer surgery now being cancelled as well throughout different hospitals in Wales.

"But, also, the reason why the operations are being cancelled is because surgical beds are full of medical patients."

What are winter pressures?

Although the NHS is under pressure all year round, the period after Christmas and the first few weeks of new year is often the most difficult as staff try to deal with significant numbers of seriously ill patients.

There are several reasons for this - as a result of the festive season's bank holidays, there has been reduced access to community services such as GPs and social care, which can cause logjams to develop in hospitals.

During the holiday period, people might also put off getting a potential health problem checked out.

Flu season in Wales GP consultation rate for influenza-like illness, consultations per 100,000 patients, by week

Pressures are also caused because of winter bugs, with the current flu season already looking worse than last year.

But the latest weekly flu statistics show a slight fall in patients seeing their GP - with Public Health Wales saying it remains at "medium intensity" for the season.

There were 197 cases of flu confirmed - and fewer patients turning to out-of-hours doctors' services.

The Welsh Government said it had given £30m to health boards to provide extra capacity this winter.

Helen Howson, the director of the Bevan Commission, a think-tank which provides advice to the health minister, said there were "increased demands on the system".

"What we have to do is to make sure that the system that we have in Wales, both the health and care system, is sustainable for the future," she said.

"That will need people to change and for the public to work with us to be part of finding some of those solutions."

Plaid Cymru Mid and West Wales AM Helen Mary Jones criticised First Minister Mark Drakeford for previously describing arrangements in place at the health board as "resilient".

"I would like to suggest that he comes to the Hywel Dda health board area, and explains that to my constituents, because this doesn't look like a set of resilient or acceptable arrangements to me," she said.

Angela Burns, spokesperson for the Conservatives on health, said health board chief executive Steve Moore had told her staff had worked on their days off and cut short holidays.

"This is not about the front-line effort and commitment and dedication, it's about the planning side of it," she said.

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