Elwyn Vaughan MS has warned that plans to cut community hospital beds in Powys risk deepening pressure on an already stretched rural health system, as he urged campaigners to fight for an alternative rather than simply say “no”.

With around 26 percent of Powys residents already aged over 65, and that figure projected to rise to 38 percent within a decade, Mr Vaughan said the direction of travel made little sense.

“I just can’t see where they are going to get the extra carers to make up for that,” he told Cambrian News.

He fears the effects would reach beyond Powys, worsening pressures at Bronglais and Shrewsbury.

The issue is also personal. A relative of Mr Vaughan was unable to leave Shrewsbury Hospital this summer until, he pushed for her transfer to Llanidloes, where her care “rejuvenated her”.

But he is keen not to be seen as a politician simply promising to stop change.

“People just shout, and politicians are as bad as anybody, ‘No’ to those changes,” he said. “But actually there has to be a focus on positive alternatives.”

That also shapes what he says elected politicians can realistically do.

Mr Vaughan said there was a misconception that an MS, or even the Health Minister, could simply halt processes. Legislation brought into force in May 2023 changed how service change disputes are handled, with Llais taking over the representation role.

Welsh ministers “cannot become directly involved in a dispute that could later reach them for determination” because doing so could prejudice the process.

He compared it to his time on Powys’s planning committee, where a councillor already involved in an application could not then take part in deciding it. “So we have to use the system as we understand it”.

Mr Vaughan’s alternative is not simply to preserve the system, but to strengthen rural healthcare around existing community hospitals rather than removing beds.

He wants Bronglais developed as a “Centre of Rural Health excellence”, with Llanidloes and Machynlleth closely integrated into its services.

His wider proposal also includes reviving the recommendations of the 2014 Longley report, establishing a cancer diagnostic centre and surgical hub in Powys, and finding a long-term solution to cross-border treatment.

For now, he wants residents to use the consultation process and Llais to press for a different approach.

He is also deeply sceptical about the consultation itself. “There’s a great deal of cynicism. I think it’d be better if they paused and actually gave three or four options.

“The danger is that people either don’t want to participate because they think it’s a done deal, or they participate and they come back and ratify one of those options anyway.

“That’s not a healthy thing for democracy.”

Beyond the immediate battle over beds, Mr Vaughan believes the structure of healthcare in Wales also needs more fundamental reform.

“I have come to the conclusion that we need to get rid of health boards” describing the current structure as “not fit for purpose”.

“Where is the vision for the future?” he said.

“If other rural areas can do it, I’m sure we can!”