THE HEAD of the NHS has admitted that the Welsh Assembly Government has failed to win the public's hearts and minds over the reconfiguration of health services.
Ann Lloyd, chief executive of NHS Wales, said the government has not explained what community services will replace those lost from hospitals.
And she said that the government has only a year to inform the public.
Concerns about the future of health services - particularly hospital-based services - have sparked a series of protests, demonstrations and petitions around Wales.
Many people have raised concerns that services will be lost from the area and because they do not know what community-based services will be available in the future, they are worried that patients will have to travel further distances for healthcare.
The Assembly Government wants more healthcare to be provided in the community and for people to be kept out of hospital as much as possible.
But, as yet, no details about new community-based services have been published - only plans to reconfigure hospital services.
Speaking at a summit on devolution and health policy, organised by drugs manufacturer Pfizer, Mrs Lloyd said, "What I think we have failed to do is to describe and show the alternatives.
"The building itself [the hospital] is a representation of something that was achieved by the community. So there is a mourning and attachment to a building, irrespective of the service.
"There are people who have managed to change their services fundamentally and they have had to work really hard to engage that population effectively.
"Over the next year, if we do not get that engagement right, some services are just going to crash."
Although both First Minister Rhodri Morgan and Health Minister Dr Brian Gibbons have spoken of the need to ensure the public understand the reason for the changes, this is thought to be the first time such a high-ranking official has admitted the strategy so far has failed.
Dr Tony Calland, chairman of the British Medical Association's Welsh Council, said, "We are generally supportive of reconfiguration because the NHS needs to change and we need to get it working in an efficient manner.
"There is a lot of talk about closure of this and that, particularly community hospitals, which people see as a reduction in services.
"But in terms of handling the PR of change of that magnitude, people need to see what is going to be put in place to replace the services that are going to be shut down, before they are shut down."
Mike Ponton, director of the NHS Confederation, said, "The NHS has changed beyond recognition in the past couple of decades, but the public's ideas about how the NHS works can often lag behind the reality.
"We need to find better ways of communicating this, and be more effective in engaging with the public on the issues that we all face.
"It is quite right that there is a vigorous debate about the future of health services. But that debate has to be based on an up-to-date understanding of modern healthcare.
"Making sure our communities have that understanding, and engaging with them in that debate, is an essential part of the work of NHS organisations."
A spokesman for the Welsh Assembly Government said, "It is clear that people do have a strong affection for their local hospitals and services.
"This has been demonstrated by the response to proposals across Wales to modernise health services. However, services do need to change.
"Patients need to know that the current facilities will remain until the replacement services are in place.
"In some circumstances, the process of change has been hindered by the lack of an effective engagement with key stakeholders and interest groups.
"It is important that we learn from this. It is also important that patients understand how the change will take place from present arrangements to future improved services."
Public demonstrations at plans to shut down services or even entire hospitals have been held throughout Wales - page 2