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
‘Postcode lottery’ concerns over fertility treatment

COUPLES seeking fertility treatment in Wales face a postcode lottery in terms of access to services, a Senedd Member warned.
James Evans, the Conservatives’ shadow health secretary, said the eligibility criteria for NHS-funded fertility treatments varies across the country.
Mr Evans called for the Welsh Government to standardise the criteria to make sure everyone has equal access to treatment and provide people with greater choice.
He said: “There are notable differences in the fertility treatments offered across different health boards and patients often lack autonomy to choose their preferred treatment centre.”
Mr Evans raised the example of ICSI, a treatment for men with infertility, during health questions in the Senedd on February 12.
He said: “For those people with low sperm counts, that is the only way in which they can actually access fertility treatments but some centres don’t do that.”
Peter Fox cautioned that male infertility issues are often overlooked despite studies showing that male factors contribute to 30% to 50% of cases in Wales.
He added: “When males are diagnosed… they’re often left in the dark with no support offered to them because most of the treatment services are focused toward the women.
“A lot of those men are left feeling frustrated – they feel shame, they feel anger – because they don’t feel like they get the mental support needed to get through that time in their lives.”
Standing in for health secretary Jeremy Miles, who was ill, Sarah Murphy, the mental health minister, said one in six couples will struggle with infertility.
She explained that the Human Fertilisation and Embryology Authority regulates the NHS and private sector, setting out the treatments and procedures available.
Raising commissioning policy on fertility services, Ms Murphy stressed: “I think it’s really important to emphasise, though, that this is a specialist service.

“It is not something that is provided across every health board.”
Ms Murphy pointed to services provided in clinics in Cardiff and Swansea, adding: “I understand completely that there will be people out there where this is not ideal, I do.”
She told the Senedd: “There absolutely shouldn’t be any shame or stigma around this – it’s not as uncommon as maybe people think.”

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, warned of high levels of homelessness, mental health issues and financial insecurity among unpaid carers.
He said only 6% of unpaid carers were able to access personal needs assessments during 2024 despite a right to one being enshrined in Welsh law a decade ago.
Mr ap Gwynfor raised concerns about a “chronic lack of capacity” to conduct assessments, with councils facing spending pressures of £559m in 2025/26.
Dawn Bowden, the Welsh Government’s social care minister, recognised the picture, saying: “This is something that I hear consistently from unpaid carers … and carers’ organisations.”

Ms Bowden added: “I want to reassure you, Mabon, that we know we are nowhere near where we need to be with this and this is very much a priority piece of work.”
Plaid Cymru’s Sioned Williams said one in three women will have an abortion in their lives as she criticised a lack of services within Wales despite warnings since 2018.
She told the Senedd that nowhere in Wales offers surgical termination beyond 16 weeks nor any type of abortion after 20 weeks.
Ms Williams said: “If a woman needs access to abortion services beyond this up to the legal limit of 24 weeks, they must travel out of Wales for treatment, usually to Liverpool or London.

“Although abortions at later gestations account for only 2% of all abortions, the women who require them are some of society’s most vulnerable.”
Ms Murphy pointed to the ten-year women’s health plan, adding that she has sought to move the issue up the agenda with work on a specialist abortion service under way.
Health
Ultra-processed foods ‘fuelling public health emergency’

SENEDD Members warned of a public health emergency due to the dominance of ultra-processed food in people’s diets.
Labour’s Jenny Rathbone led a debate on a cross-party motion which was co-submitted by the Conservatives and Plaid Cymru.
She told the Senedd: “The food industry spends billions promoting our disastrous diets and we have to use the power of community to fight back.”
Ms Rathbone warned: “There’s no time to lose. The ever-escalating diabetes epidemic is already devouring 17% of the NHS budget.
“The levels of malnutrition among hospital patients are prolonging patient stays, and the main driver of early death and chronic illness is not smoking but our obesogenic diets.”
The Conservatives’ Peter Fox introduced an ultimately unsuccessful bill on sustainable production and food security in 2021.
“We don’t need data to show that things are getting worse,” said Mr Fox, a farmer and former council leader. “It’s clearly evident all around us.
“We see growing levels of obesity across our population and, worryingly, a significant rise in childhood obesity leading to serious health-related issues, such as childhood diabetes.”
During the February 12 debate, Plaid Cŷmru’s Llyr Gruffydd warned that too many people in Wales struggle to access fresh, healthy and affordable food.
He urged ministers to make greater use of public procurement to improve food in schools, hospitals and care homes while supporting Welsh producers.
Labour’s Lee Waters broadly agreed, telling the Senedd that only about 6% of fruit and veg used by the Welsh public sector is grown in Wales.
He said: “What’s stopping us from supporting Welsh farmers and buying local? Well, we don’t grow enough veg for a start, so there’s an opportunity for farmers to embrace horticulture to create new sources of income.”
But the former minister stressed the need to influence the private sector, with the value of all public food procurement equivalent to the annual turnover of one big supermarket.
Warning of a public health emergency, Alun Davies, a fellow Labour backbencher, urged the Welsh Government to put food centre stage.
He said: “I think it’s no exaggeration to say that obesity is an absolute national emergency and it’s not a national emergency that is an act of God; it’s an act of capitalism.”
Huw Irranca-Davies said the Welsh Government’s community food strategy would be published as soon as possible as he pointed to spending on local food partnerships.
The Deputy First Minister, who is responsible for food policy, described the food sector as a real success story employing 228,000 people or 17% of Wales’s workforce.
Ms Rathbone argued the community food strategy will be insufficient, warning a lack of follow through and rigorous execution has left Wales a very pale imitation of Scotland.
She said: “France and Italy would never have allowed their children to be sold the second-class food that is being served in our schools today.
“And I want to see the commitment to actually ban ultra-processed food from all public procurement – that is what we need to work towards.
“We can’t achieve it overnight but we need to set a date and do it.”
Health
Nursing applications rise but concerns remain over long-term decline

RCN Wales calls for urgent action as Cardiff University faces cuts
THE NuMBER of applicants for nursing courses in Wales has risen by 14% this year, but the Royal College of Nursing (RCN) warns that the longer-term decline remains a major concern.
Figures from the Universities and Colleges Admissions Service (UCAS) show applications for 2025 nursing courses have increased from 3,050 to 3,480. However, since 2021, applications have fallen by 15%, down from 4,090.
Helen Whyley, Executive Director of RCN Wales, welcomed the rise but warned that it does not reverse years of declining interest in the profession.
“This increase in applications is a positive step, but we remain deeply concerned about the long-term decline in nursing applicants in Wales,” she said. “The health care system is already under immense pressure, and without sustained investment in nursing education, we risk deepening the workforce crisis.”
Cardiff University nursing cuts ‘alarming’
Ms Whyley also criticised Cardiff University’s proposed closure of its School of Nursing, warning that it would have serious consequences for Wales’ health services.
“RCN Wales is alarmed by Cardiff University’s current proposals,” she said. “Any reduction in nursing education provision would have significant implications for the future workforce and the ability to meet health care needs across Wales. We urge Cardiff University and policymakers to prioritise investment in nursing education and ensure that opportunities for aspiring nurses are expanded rather than reduced.”
Need for more nursing education places
Despite steady commissioning figures for nurse education places in Wales, RCN Wales argues that numbers must be increased to match growing demand.
Ms Whyley added: “RCN Wales will continue to advocate for sustained investment in nursing education, ensuring that Wales has a well-supported, well-educated nursing workforce now and in the future. The RCN urges the Welsh government, universities, and health leaders to work together to secure the long-term sustainability of nursing education and protect the future of the profession.”
With thousands of nursing vacancies still unfilled across Wales, the RCN is calling for urgent action to ensure the next generation of nurses can be trained and supported in their careers.
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