Cardigan Soroptimists have added their voice to the protests over bed closures at Cardigan Hospital.
In a strongly worded letter to Hywel Dda chief executive Trevor Purt, the group accuse the health board of a "lack of honesty and clarity" about "these major changes".
"The LHB has not allowed any time for consultation with the community thus robbing them of the opportunity to give their views on such a radical change in the provision of healthcare in Cardigan and the surrounding area," they say.
They also raise concerns at the lack of beds in the three major district general hospitals and the distances involved.
"This area has an increasingly ageing population, to this end Cardigan Hospital has provided emergency care beds when the sick have required care after an episode of worsening health at home without the added stress of a long journey to a general hospital."
The Soroptimists criticise the options of using local nursing homes and Tregaron Hospital plus the delay with building the new hospital.
"We feel that in your deliberations you have not considered the ages and personal circumstances of people living in this area."
And they add: "We fully support the action of Cardigan Hospital league of Friends in protesting most strongly against the reduction of services and facilities before the new hospital is up and running."
In his reply Mr Purt confirms that the hospital will not close until the new facility is constructed.
: "The building is now significantly sub standard and unable to fulfill the full range of services that are required of it, " he says.
He says that beds are being "reprovided" in the community and says that delays with the new hospital have hopefully been overcome and plans can now "speedily move forward."
And he adds: "To be clear the function of Cardigan Hospital is not to provide emergency care beds and it is not the role of the NHS to replace what should be local authority provision ie respite care/nursing and residential care."