Health
Cancer patients face long waits for diagnosis and treatment in Wales
A REPORT released by Audit Wales has revealed that cancer care in Wales continues to struggle with significant delays in diagnosis and treatment, highlighting the need for urgent improvements. Despite increased investment in recent years, no health board has met the national target that 75% of cancer patients should begin their first treatment within 62 days since August 2020.
The report, embargoed until January 14, 2025, stresses that stronger national leadership and a sharper focus on preventative measures are critical to addressing these persistent challenges.

National targets missed
Audit Wales noted that while survival rates for cancer patients in Wales have improved, they remain poor compared to other countries. Wales has the second-highest cancer mortality rate in the UK, behind Scotland. The disparity is especially evident for individuals living in deprived areas, where outcomes are significantly worse.
Since the COVID-19 pandemic, performance has stabilized between 52% and 61% of patients starting treatment within the target timeframe. For some cancers, such as lower gastrointestinal, gynaecological, and urological cancers, waiting times exceed 100 days for certain patients, underlining the urgency of the problem.
Screening and early detection
Early detection is key to improving survival rates, with screening playing a vital role. The report praised the expansion of the national bowel screening programme, which now reaches more people using a more sensitive test. However, it pointed to opportunities to increase uptake for breast and cervical cancer screenings and urged a decision on introducing a national lung screening programme.
Rising demand and staffing challenges
The demand for cancer diagnosis and treatment in Wales is growing. Between 2002 and 2021, the number of newly diagnosed cancers rose by 22%. Suspected cancer referrals have also increased, creating additional strain on the NHS. Notably, more than 84% of these referrals ultimately determine that the patients do not have cancer.
Staffing gaps and capacity limitations further compound the issue, with waiting lists for cancer services continuing to grow. Despite Welsh Government ambitions to return waiting lists to pre-pandemic levels, the report suggests this goal is unlikely without significant increases in diagnostic and treatment capacity.
Leadership and prevention
The report emphasizes the importance of clear national leadership in addressing the challenges facing cancer services in Wales. It noted weaknesses in current oversight arrangements, particularly concerning the status of the NHS Wales Cancer Improvement Plan, launched in 2023. Clarity is needed on how this plan integrates with other initiatives to drive the required improvements.
Preventative measures were also highlighted as critical. Approximately 40% of cancers in Wales are preventable, with lifestyle factors like smoking, diet, and physical inactivity contributing to risk. Tackling these factors could save lives and reduce pressure on the NHS, as these same risks also contribute to other major health conditions.
A call to action
Auditor General Adrian Crompton stressed the importance of addressing these challenges, stating:
“Despite increased investment, too many people are experiencing unacceptably long waits for cancer diagnosis and treatment. Variations in performance persist, and insufficient attention is being placed on prevention of lifestyle factors that cause cancer. National leadership and oversight must be clarified and strengthened as a matter of urgency.”
Moving forward
The Welsh Government is responsible for setting the strategic direction and holding health boards accountable for their performance. Health boards and trusts are tasked with planning and delivering services to meet national targets.
The report is a stark reminder of the work needed to ensure timely cancer care for all. The publication serves as a rallying call for coordinated action across government, health boards, and communities.
For anyone affected by the report’s findings, details of support services can be found through the Wales Cancer Alliance.
Health
Fresh alarm over life expectancy in Wales as CMO warns of ‘prevention revolution’
WALES is living sicker for longer, the Chief Medical Officer has warned, as new figures show a worrying drop in the number of years people can expect to live in good health – with women hit hardest.
The findings, published today in Dr Joanne Absolom’s first annual report since taking over from Sir Frank Atherton, have prompted immediate calls for the next Welsh Government to overhaul its approach to public health after the 2026 Senedd election.
Dr Absolom says Wales must now move decisively away from a system that largely treats illness towards one that prevents people becoming ill in the first place. Her report warns that healthy life expectancy is falling across the country and highlights widening inequalities between communities.
Responding to the findings, Darren Hughes, Director of the Welsh NHS Confederation, said the message could not be clearer.
“NHS leaders in Wales welcome the report’s call for a prevention-first approach,” he said. “We have to move from simply treating illness to actively promoting wellbeing, and that means a proper cross-government strategy that tackles inequality and gives people the support to take control of their own health.”
He added that every pound spent on proven public health programmes delivers an average return of £14 – evidence, he said, that prevention “makes moral and financial sense” at a time when NHS budgets are under extreme pressure.
“It is deeply concerning to see healthy life expectancy falling, particularly for women,” he said. “Investment in prevention is vital if we are to make our health and care services sustainable.”
While health boards, councils and community groups are already working on preventative programmes, the Welsh NHS Confederation says Wales needs far greater ambition – and the NHS must be given the tools and flexibility to scale up what works.
The Chief Medical Officer’s report also raises serious concerns about NHS workforce shortages and urges significant investment in digital technology to improve productivity and patient outcomes.
Mr Hughes said all political parties should “take heed” as they prepare their manifestos for next year’s Senedd election.
“Those seeking to form the next Welsh Government have a clear blueprint here. We cannot keep doing the same things and expect different results. Prevention, workforce and digital transformation have to be top priorities.”
The Welsh NHS Confederation — which represents all seven health boards, the three NHS trusts, HEIW and Digital Health and Care Wales — has already outlined its detailed priorities in its own election document, Building the health and wellbeing of the nation.
With the Senedd election just over a year away, today’s report adds fresh, authoritative evidence that Wales needs a radical shift in how it approaches health if it is to secure a healthier future for all.
Health
Government orders clinical review amid sharp rise in mental health diagnoses
4.4 million working-age people now claiming sickness or incapacity benefit, up by 1.2 million since 2019, many because of a mental health condition
A CLINICAL review into how mental health conditions are diagnosed across the UK is expected to begin this week, following concerns within government over rapidly rising sickness-benefit claims linked to conditions such as autism, ADHD and anxiety.
Health Secretary Wes Streeting has commissioned leading clinical experts to examine whether ordinary emotional distress is being “over-pathologised” and to assess why the number of people receiving sickness and incapacity benefits has grown to 4.4 million – an increase of 1.2 million since 2019.
According to reports in The Times, ministers are particularly alarmed by the surge in the number of 16- to 34-year-olds now out of work because of long-term mental health conditions.
Streeting said he recognised “from personal experience how devastating it can be for people who face poor mental health, have ADHD or autism and can’t get a diagnosis or the right support,” but added that he had also heard from clinicians who say diagnoses are “sharply rising”.
“We must look at this through a strictly clinical lens to get an evidence-based understanding of what we know, what we don’t know, and what these patterns tell us about our mental health system, autism and ADHD services,” he told the newspaper. “That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.”
The review is expected to be chaired by Prof Peter Fonagy, a clinical psychologist at University College London specialising in child mental health, with Sir Simon Wessely, former president of the Royal College of Psychiatrists, acting as vice-chair.
Prof Fonagy said the panel would “examine the evidence with care – from research, from people with lived experience and from clinicians working at the frontline of mental health, autism and ADHD services – to understand, in a grounded way, what is driving rising demand.”
The move comes as the UK Government faces mounting pressure over the rising welfare bill. Ministers earlier this year pulled back from proposed changes to disability benefits, including those affecting people with mental health conditions, after opposition from Labour backbenchers.
Speaking on Monday, the Prime Minister said a fresh round of welfare reform was needed.
Keir Starmer said: “We’ve got to transform it; we also have to confront the reality that our welfare state is trapping people, not just in poverty, but out of work.”
Health
NHS Trust CEO ‘forced out’ after raising concerns — Welsh Govt denies wrongdoing
A CONSERVATIVE MS has pressed the Welsh Government for answers after the sudden departure of the Velindre University NHS Trust’s chief executive, amid media reports that he raised concerns about alleged governance failures within NHS Wales Shared Services.
During Health Questions in the Senedd today, James Evans MS asked Health Secretary Jeremy Miles to explain why former CEO David Donegan left his post after just a year. Reports circulating in recent weeks suggest Mr Donegan had raised issues relating to governance, and in some accounts, possible criminality. These claims have not been substantiated publicly.
Velindre’s own 2024/25 annual report notes that the Trust “escalated concerns to Audit Wales and Welsh Government about the current governance of Shared Services, which hadn’t been reviewed since 2012.” No details of the concerns have been published.
Welsh Government response
Jeremy Miles MS confirmed in the chamber that correspondence relating to the issues does exist, but said it would not be appropriate to release sensitive material while internal processes are ongoing. He did not comment on the circumstances of Mr Donegan’s departure, citing employment confidentiality rules which are standard across the NHS and public sector.
A Welsh Government spokesperson has previously said that they expect all NHS bodies to follow “proper governance and HR procedures,” and that they “do not comment on individual employment matters.”
Velindre NHS Trust position
Velindre has not publicly stated that Mr Donegan was removed because of whistleblowing activity. The Trust has described his departure simply as a “change in leadership” and says it continues to engage with Audit Wales and the Welsh Government on governance matters.
Opposition criticism
After the exchange, James Evans MS — the Welsh Conservative Shadow Cabinet Secretary for Health — criticised the Health Secretary’s “lack of transparency”.
He said:
“I am extremely disappointed with the Health Secretary’s refusal to provide clarity on the circumstances surrounding Mr Donegan’s departure, or to release the correspondence relating to governance concerns within Shared Services. The public must be able to trust that millions of pounds of NHS funds are being managed properly.”
Mr Evans said he will write to the First Minister and Cabinet Secretary formally requesting the publication of correspondence “in the interests of full accountability.”
Context: What is NHS Shared Services?
The NHS Wales Shared Services Partnership (NWSSP) manages national procurement, payroll, recruitment, estates services and other core functions for health boards and trusts. It sits within Velindre University NHS Trust but operates independently of its operational healthcare work. Governance arrangements for NWSSP were originally set a decade ago and are subject to periodic review by Audit Wales.
There is no evidence at present of wrongdoing by the Welsh Government or NWSSP, beyond the concerns referenced in Velindre’s annual report.
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