Health
Call for overhaul of ‘unsustainable’ GP funding model
SENEDD members added their voices to a chorus of calls for fair funding for GPs after more than 21,000 people across Wales signed a petition.
Carolyn Thomas led a debate on the petition submitted by the British Medical Association (BMA) as part of the professional body’s “Save our Surgeries” campaign.
The Labour politician, who chairs the petitions committee, attended a meeting with GPs and told the Senedd their message was clear: the current funding model is unsustainable.
She said: “Over the last two decades, while the number of face-to-face appointments, digital contacts and phone calls has risen, the complexity of the work has been transformed, expenses have risen, and the cost of premises has leapt up.
“Yet the share of the health budget spent on GP services has shrunk..”
Ms Thomas, who represents North Wales added: “In some areas, recruitment and retention is the main worry but in others it’s the crumbling fabric of buildings. In others, it is the rapidly ageing population or a growing workload that isn’t matched by an equivalent rise in capacity.
“But underlying all of these is money to pay for the services that we all want to see.”
Sam Rowlands, the Conservatives’ shadow health secretary, said 8% of NHS Wales funding goes to GPs which is lower than levels from 2005/06.
Mr Rowlands pointed out that more than 100 surgeries have closed in the past 12 years.
Plaid Cymru’s Heledd Fychan criticised “huge underinvestment” over the past decade, telling the Senedd that Wales remains 500 GPs short of the OECD average.
She said: “There were 372 GP services in Wales at the end of June, which is 14 fewer than when the BMA launched the ‘Save Our Surgeries’ campaign. It is clear, therefore, that these consistent warnings about a shortage of provision … have fallen on deaf ears.”
Ms Fychan, who represents South Wales Central, raised concerns about big companies, often located outside Wales, stepping into the market for GP services.
She said: “In the Aneurin Bevan area, eHarleyStreet is a clear example of this. This continues with the damaging trend of profits being taken out of the health system into private pockets, and also makes the provision vulnerable.”
Her Plaid Cymru colleague Luke Fletcher raised a BMA survey that found nearly four out of five locum GPs cannot find work despite patient waiting times hitting record highs.
He said: “That’s in England but here in Wales the symptoms of the same crisis have been visible for a while, yet the data doesn’t seem to be available….
“Anecdotally, I’ve been told of locums in Wales looking to other fields. Some are considering jobs in retail and driving taxis. At a time when we’re crying out for GPs and we all accept that there’s a shortage of GPs – this situation is madness.”
Warning services are in chaos, the Conservatives’ Laura Anne Jones raised concerns about a survey showing 37% of Welsh GPs may leave the profession within five years.
Julie Morgan said she has heard the same story from surgeries in her constituency: “They’re struggling to maintain safe levels of service and worried about being able to continue.”
The former minister told the Senedd that Cardiff North is in the bottom 1% of funded practices in the UK due to the “outdated” Carr-Hill formula used to calculate funding.
Jenny Rathbone, a fellow Labour backbencher, highlighted the Deep End Cymru project, which aims to support 100 practices in the most deprived areas.
Jane Dodds, the Liberal Democrats’ leader in Wales, raised concerns about staff welfare and reiterated calls for a premium to recognise the significant challenges for GPs in rural areas.
Responding to the debate on November 6, Jeremy Miles said surgeries in Wales see an astonishing number of patients with around 1.5 million every month.
Wales’ health secretary stressed: “I want to reassure GPs that we have heard the messages about the huge demands and the pressure on staff welfare.”
Mr Miles said ministers have chosen to commit £1bn over this Senedd term to clear the backlog and reduce waiting times following the pandemic.
He told the Senedd: “By necessity, this means that a larger proportion of funding has gone to secondary care. Redressing this imbalance will be a priority for future funding decisions.
“And we are committed to the principle of providing more care closer to home.”
Community
‘Extreme anxiety, anger and distress over fuel poverty’
THE OLDER people’s commissioner for Wales called for funding to alleviate the impact of winter fuel payment cuts amid “extreme anxiety, anger and distress” over fuel poverty.
Rhian Bowen-Davies urged the Welsh Government to set up a distinct fund for older people to mitigate against Westminster’s decision to introduce means-testing.
Ms Bowen-Davies, who was appointed for a seven-year term in July, warned the withdrawal of universal winter fuel payments will have a significant impact.
She told the Senedd’s equality committee: “I felt that this decision was the wrong decision… it should have been reversed, I think that opportunity has been missed with the budget.”
She added: “I felt the approach was wrong in terms of it being rushed through and I also felt the timeline was unrealistic for people to apply.”
The new older people’s commissioner, who is a former police officer, welcomed the Unite union taking legal action to try to overturn the cuts.
Giving evidence to an inquiry on fuel poverty, she told the committee an estimated 50,000 households in Wales are eligible for pension credit but do not claim the extra income.
Warning the eligibility criteria for the Welsh Government’s discretionary assistance fund is too narrow, she urged ministers to follow the example of Northern Ireland and Scotland.
Ms Bowen-Davies pointed to a £100 payment for all older people in Northern Ireland this winter, with no application needed and a similar scheme set to follow in Scotland.
She raised concerns about the Welsh Government’s refreshed Warm Homes programme, with a lack of boiler repairs leaving some households without heating and hot water.
She told the committee the boiler replacement scheme has since opened but only until March as she called for a better balance between warm homes and decarbonisation.
Age Cymru highlighted a “huge” 1,144% increase in calls to its advice line about winter fuel payments and a 99% rise for pension credit enquiries from 2023 to 2024.
Ceri Cryer, Age Cymru’s policy adviser, raised similar concerns about the equality impact of an emphasis on heat pumps that are inappropriate for some homes.
She warned the upfront and ongoing costs of heat pumps are beyond many people’s means.
Rebecca Hill, a senior public health specialist at Public Health Wales, expressed concerns about a trend towards older people skipping meals and cutting back on heating.
Dr Hill said: “We know that colder homes are linked to heart and lung conditions, infectious respiratory illnesses such as flu. We also see higher rates of deaths in cold months … and we know a majority of those deaths accrue amongst our oldest population.”
She also pointed to evidence that older people in colder homes have higher blood pressure and cholesterol, problems with sleep and reduced physical performance, leading to falls.
Ms Bowen-Davies warned older people are experiencing “extreme anxiety, anger and distress” as she called for interim targets in the Welsh Government’s fuel poverty plan.
Raising concerns about the disproportionate impact of the cost-of-living crisis, she pointed out that many older people have to budget for soaring bills from a fixed income.
She told the meeting on December 9: “What older people are saying to me is they are having to make really difficult decisions in terms of how much they are eating on a daily basis and the individual rooms that they are heating.”
Health
Over one in four care seekers in Wales unsure who will pay for care as costs soar
A NEW report has uncovered significant uncertainty surrounding elderly care funding in Wales, with more than a quarter of care seekers unsure who will bear the costs. Data from carehome.co.uk, a leading reviews website, shows that 26% of Welsh care seekers who inquired between November 1, 2023, and October 31, 2024, did not know how their care would be funded—surpassing the UK national average of 21%.
Self-funding: A growing trend
Among those with a clear funding plan, 41% in Wales stated they would self-fund their care. This figure compares with 53% in England, 40% in Northern Ireland, and 37% in Scotland, highlighting regional differences in funding approaches.
Local authority funding and the rise of top-up fees
The research reveals that 13% of Welsh care seekers rely on local authority funding, aligning with the UK average. However, with local councils under financial strain and care home fees climbing, many families face additional “top-up” costs to bridge the gap between council contributions and actual fees.
In Wales, 13% of care seekers anticipate paying top-up fees, a growing challenge as families struggle to meet rising expenses.
NHS continuing healthcare: A complex system
Only 7% of care seekers in Wales expect to benefit from NHS continuing healthcare funding, slightly above the UK average of 5%. This funding, which is not means-tested, covers full care costs for adults with complex health needs. However, critics point to inconsistencies in assessments across regions.
James Urquhart-Burton, a partner at Ridley and Hall Solicitors, described the issue:
“Your chances of getting NHS continuing healthcare funding vary based on your location, which is a problem given that the criteria are standardized nationwide. The reliance on assessors’ judgments to determine need introduces subjectivity into the process.”
Rising costs and public confusion
Sue Learner, editor of carehome.co.uk, expressed concern over widespread confusion about care funding:
“Our data shows an acute lack of understanding among the public in Wales about how the social care system works and how to navigate it. It’s incredibly concerning that a significant proportion of care seekers still don’t know whether the council or they themselves will cover costs.”
Learner highlighted the financial strain on self-funding residents, with care home fees in Wales averaging £1,066 per week. Rising costs—driven by increases in National Insurance, the National Living Wage, energy bills, and food prices—add to the burden.
“Care homes are increasingly prioritizing self-funding residents due to financial pressures,” she added. “This trend may reduce the number of care homes accepting state-funded residents, leaving families to grapple with an already complex system.”
As care costs continue to rise, understanding funding options and planning ahead are becoming critical for families across Wales.
Pictured: Shani Lauren Escott at Pen Coed Care Home, Saundersfoot with resident May Spurr
Health
18,000 families ‘struggling in silence’ due to lack of dementia diagnosis
AROUND 18,000 people living with dementia in Wales do not have a diagnosis, leaving families struggling to cope without support and treatment, Senedd Members warned.
Mabon ap Gwynfor said Wales has the lowest rate of diagnosis in the UK at 56%, warning that dementia is one of the biggest causes of death in the country.
Plaid Cymru’s shadow health secretary paid tribute to Terry Griffiths, the former snooker world champion from Llanelli, who died on Monday following a long battle with dementia.
Mr ap Gwynfor raised an estimate from Alzheimer’s Society Cymru of a 37% increase in the number of people living with dementia by 2040 due to an ageing population.
He told the Senedd that dementia costs the Welsh economy £2.3bn a year, which is expected to double to £4.6bn by 2050 if services do not improve.
Leading a debate on a Plaid Cymru motion calling for diagnosis targets, Mr ap Gwynfor said: “Around 18,000 people are left to cope without the support and treatment they need.
“That’s 18,000 individuals and 18,000 families struggling in silence, without knowing what to do or where to turn. The situation is even worse in rural areas, such as Powys.”
Gareth Davies warned dementia is Britain’s biggest killer, yet spending on diagnosis makes up less than 1.4% of UK health care expenditure, “which seems a staggering oversight”.
He said families are shouldering 63% of dementia-related costs, according to Alzheimer’s Society, with the average bill standing at £29,000 a year rising to £80,000 or more.
His Conservative colleague Altaf Hussain, a former surgeon, focused on alcohol-related dementia and brain damage, warning it is difficult for GPs to identify.
Delyth Jewell said her grandma Doreen, who lived to be 100, had dementia.
She told the Senedd: “The cruellest thing about dementia is how bewildering it is for the person going through it. My parents would visit my grandma. They’d call her multiple times each day. But she’d forget that they’d been.
“She’d think that they’d forgotten her. I remember her calling my parents’ house one day, and I’d answered the phone, and she’d asked me, ‘Why is it that I can’t do all the things I used to do?’ and she wished that she could walk and walk.
“She’d get frustrated, she’d be lonely and she couldn’t understand why it was happening.”
Ms Jewell, who represents South Wales East, said diagnosis rates are stubbornly low at 60% in the Aneurin Bevan health board and “there’s still no dementia plan for Gwent”.
Heledd Fychan, a fellow Plaid Cymru Senedd Member, called for greater support for Welsh speakers living with dementia, warning their needs are too often disregarded.
Mike Hedges, who represents Swansea East, said: “Increasing diagnosis rates across Wales is vital to enable people … to take control of their condition and live independently for longer.
“This supports people to stay out of hospital and in their own homes, relieving pressure on our health and care system.”
Responding to the debate on December 4, Sarah Murphy told the Senedd an independent evaluation of the Welsh Government’s dementia action plan will be published in early 2025.
The mental health minister, whose responsibilities include dementia, said the final report will inform a refreshed plan that will include new targets for diagnosis.
She said: “Ensuring people’s lived experience is at the heart of the development of services is very important to me, and I am committed to the development of robust diagnosis data.”
While the Plaid Cymru motion was defeated, 27-25, a version amended by the Conservatives and the Welsh Government was agreed unanimously.
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