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Wales has too many hospitals and too many beds according to Finance Minister Mark Drakeford.
The former Labour first minister told the "For Wales, See Wales" podcast that Wales was "over hospitalised" and that more money should be spent on primary care.
He said the hospital sector "sucked resources" in the health service, but that most people's experience of using the NHS was via their GP surgery.
Welsh Conservatives have criticised a lack of hospital beds in Wales in recent Senedd exchanges and said Drakeford's podcast comments demonstrated "Labour's disconnect after 26 years in power".
Drakeford said: "If you're asking me if I had a blank sheet of paper and could just do the things I think needed to be done, we would have fewer hospitals in Wales. We have too many hospitals and too many beds."
"That is the truth. Secondary care, as it's called, the hospital sector, sucks the resources in the health service, and yet nine out of 10 contacts between the individual and the health service happens in primary care, in your GP surgery.
"But the money is nothing like that. The money is sucked into the hospital sector because it's so expensive to run. So the first thing I would say is we are over-hospitalised in Wales."
'Massive increase'
His comments appear to be at odds with the First Minister, Eluned Morgan.
In reply to Tory group leader Darren Millar, she told the Senedd: "We'd have loved to have built a few more hospitals, but we were given a £1 million increase when it came to capital when your government [the UK Conservative government] was in power.
"There's not much you can do with a £1m increase. Thankfully, now, we've had a massive increase as a result of the Labour government, the first significant increase when it comes to health in Wales and when it comes to capital expenditure."
She later added that there was a "recognition" that more support needed to shift to the community and that more preventative work needed to be done.
Drakeford is responsible for the Welsh government's spending plans and is currently in negotiations to try to get a deal for his budget to pass a vote in the Senedd.
He published the draft budget last month which included an extra £600m for the Welsh NHS to bring down record waiting lists, identified as a top priority by Morgan.
As well as being first minister between 2018 and 2024, Drakeford was interim cabinet secretary for health for a month in 2024 and had the job full-time for three years until May 2016.
On the podcast, he agreed with the suggestion that he would have fewer hospitals and give 50% more cash to "local" care if he had a magic wand.
When asked why he could not do that, he replied: "Well, you try proposing that a hospital in Wales closes", before going on to explain that it was an "act of faith" for people to believe that alternatives would be provided and would be better, such as more modern local facilities.
He said people were "fearful that they would get something worse rather than something better".
The Welsh Conservatives have highlighted a lack of hospital beds in recent exchanges in the Senedd, leading to angry clashes between Millar and Morgan.
On 7 January Millar told MSs that the number of beds in the Welsh NHS had fallen by over 20% since 2010 and accused Morgan and her Labour predecessors of promising to build new hospitals but failing to deliver.
Morgan replied that Millar did not understand the issue and that "a lot of people" were in beds who should not be there because of a lack of social care.
On Tuesday this week, the issue of NHS beds came up again after a report from the Royal College of Nursing on the treatment of patients in hospital corridors, which Millar said cited beds as a problem over 500 times.
The first minister said that Wales had more beds per head of population than England.
Welsh Conservative shadow health secretary James Evans said Drakeford's words on the podcast highlighted "Labour's disconnect after 26 years in power".
"Our NHS is bogged down by excessive bureaucracy and bloated management," said Evans.
"It's time for fundamental reform to prioritise patient care and fix our NHS."
Plaid Cymru health and social care spokesperson Mabon ap Gwynfor said: "On the day when waiting lists hit record highs again, a senior Labour cabinet member is making the case for less NHS resources.
"It’s a staggering reflection of Labour’s attitude towards staff and patients and how the first minister’s so-called listening exercise was a PR stunt."
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