GWENT health watchdogs believe the people of Wales accept that providing health services to country areas involves extra costs - and they want some areas not currently classed as rural to also benefit from greater investment.

The Assembly is consulting on a Rural Health Plan, to address issues specific to providing NHS services to Wales' farthest-flung communities, and Gwent Community Health Council says mid- and upper Gwent valleys communities share some disadvantages of the more remote parts of Monmouthshire, in terms of access to treatment and poor response times for specialist services, such as emergency ambulances.

A Gwent CHC report accepts health services must mainly be concentrated in centres of excellence in populated areas.

"We believe, however, that a sensible balance needs to be determined and that appropriate local and accessible services for rural communities need not just to be maintained, but developed," says the report.

"The full opportunities of new technology, particularly in terms of telemedicine, need to be exploited so those responsible for local care can have access to timely specialist advice."

The CHC is concerned that "community-based services in Monmouthshire, for both acute and mental health sectors, are noticeably less well developed than other parts of our area", the report raising concerns about services at minor injuries units in Chepstow and Monmouth, with the service in the latter town reduced following the opening of the Monnow Vale health and social care facility.

Investment in nurse practitioners, the CHC believes, would minimise the need for some patients to take 40-mile round trips to A&E at Abergavenny's Nevill Hall Hospital.

It also wants hospital appointments for rural patients to be timed to take account of often lengthy travel times. A trip on public transport from Tintern to the Royal Gwent Hospital in Newport and back by public transport can take more than five hours.

Such issues must be addressed if all patients are to have a fair deal from the NHS, says the CHC.

"We accept that providing appropriate local services to rural communities will involve additional costs but believe the investment is one the people of Wales as a whole would wish to make," says the report.