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GP shortage in Wales: Patients per doctor double European average

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THE NUMBER of patients per GP in Wales is over twice the European average, raising concerns about primary care availability for hundreds of thousands of patients across the country.

In 2024, a report by BMA Cymru Wales showed that the European average for patients per GP was around 1,000. In Wales, the average is 2,210 patients per full-time GP. Over the last decade, the average number of patients per practice has increased by just under 25%.

RURAL ISSUES

Over the past decade, the number of GP practices in Wales has decreased by 18%, dropping from 470 to 378. This decline is due to a combination of closures and mergers, reflecting broader challenges in general practice, such as workforce shortages and increasing patient demand.

The situation is worsened by the fact that around 80% of Wales’s land area is relatively sparsely populated, consisting of small settlements grouped around former market towns. New GPs are overwhelmingly concentrated in Wales’s few larger urban centres, chiefly along the M4 corridor and the North East Wales border area.

This means rural patients often have to travel significantly longer distances to access GP services compared to urban residents. The closure of rural practices forces patients to register with larger, more distant surgeries, increasing the patient-to-GP ratio. This results in longer waiting times and reduced appointment availability.

Long travel times and a lack of transport deter individuals from seeking timely care, leading to delays in diagnosis and treatment. By the time patients present for clinical care, their conditions may have worsened, making treatment more expensive and reducing the likelihood of positive clinical outcomes.

And that is before patients are placed on one of the NHS’s lengthy waiting lists for diagnosis and treatment.

The older age profile of Wales’s rural GPs was long recognised as a ticking time bomb under primary care. Yet, efforts to stem the outflow of GPs from rural Wales have been patchy and ineffective. Changes to pension rules have accelerated retirements, and as older rural GPs leave the profession, replacing them has become increasingly difficult.

The reasons are clear. Rural Wales faces huge difficulties attracting and retaining GPs due to professional isolation, fewer career development opportunities, and a lack of interest in rural practice partnerships. These factors have led to a reliance on locum doctors or salaried GPs, which in turn can disrupt continuity of care.

IN PEMBROKESHIRE

Practice closures and the shortage of GPs have hit Pembrokeshire hard.

The Argyle Medical Group in Pembroke Dock is the second-largest GP practice in Wales, with around 25,000 patients registered and just nine GPs—an average of 2,800 patients per GP. In 2021, the practice had 10.75 full-time equivalent GPs and was seeking to recruit more. However, due to a lack of available GPs, the practice was forced to withdraw from its Neyland practice at St Clement’s Surgery and reduce hours at St Oswald’s Surgery in Pembroke.

Argyle Medical in Pembroke Dock has the second-largest GP practice in Wales

As a knock-on effect of the Neyland closure, patients were transferred to the Neyland and Johnston Medical Practice, which eventually handed back its GP contract following retirements and recruitment difficulties. Its patients are now serviced by salaried and locum GPs employed by the Health Board.

The same issues have plagued GP practices from Tenby in Pembrokeshire’s southeast to St Davids in the northwest. While it would be a stretch to say that “GP deserts” exist in the same way as “NHS dental deserts,” the increasing patient load on hospitals suggests that many people are now seeking treatment at A&E for conditions that would previously have been managed by a GP.

The Welsh Government’s approach is to ask patients to self-triage before going to hospital—an impractical and, for many, heartless solution. If you are a parent with a child in agony and unable to tell you what is wrong, what would you do?

SITUATION NORMAL, SITUATION CRITICAL

In 2018, the Welsh Government announced a plan to recruit 1,000 GPs into NHS general practice in Wales. While the number of GPs has increased, it has not risen by anything close to 1,000. Worse still, the number of full-time GPs has actually fallen.

What this means is that while there are technically more GPs in total, there are fewer available in practice because many of the new recruits work part-time, as locums, or on limited contracts (for example, as doctors on call).

It’s the same statistical sleight of hand used to describe frontline clinical staff in the Welsh NHS. Welsh Government ministers proudly claim that the Welsh NHS employs more people than ever, yet the number of full-time staff has plummeted.

In an attempt to address the GP shortage, the Welsh Government has increased the number of routine clinical assessments and treatments that pharmacists and practice nurses can undertake. However, only seven relatively minor ailments can be treated by pharmacists independently, while practice nurses must have GP approval to prescribe medication.

Expanding community-based healthcare is a sensible aim, but it is undermined by the critical shortage of full-time GPs in rural Wales. There are not enough independent prescribing pharmacists or community nurses to fill the gap. The reliance on locum GPs disrupts continuity of care, leading to situations where patients are taken off long-term medication without explanation or, worse, experiencing increased risks of missed or misdiagnosed conditions.

Wales has reached a tipping point.

Politicians frequently offer warm words about “our NHS,” “our precious NHS,” and “our wonderful NHS nurses and doctors,” but none have publicly acknowledged that the foundation of NHS care—GP surgeries as the first point of contact for the sick—has buckled. If they did, they would have to come up with real solutions instead of blaming patients for being ill or making vague promises about digital medicine transforming rural healthcare.

The situation is critical.

In Wales, that passes for normal..

 

Local Government

Pension divestment debate triggered but council date still unconfirmed

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Gaza-linked petition passes 500 signatures threshold as Pembrokeshire meeting awaited

A PETITION calling for Pembrokeshire’s public sector pension fund to divest from companies linked to Israel has passed the signature threshold required to trigger a formal council debate – but no meeting date has yet been confirmed.

The e-petition, hosted through Pembrokeshire County Council’s own system, urges the authority to press the Dyfed Pension Fund to withdraw investments from firms alleged to be “complicit with Israel’s genocide of Gaza”.

Under the council’s petitions scheme, any submission receiving more than 500 signatures must be considered by councillors at a future full council meeting.

However, at the time of publication, the item does not yet appear on the council’s online agendas and minutes portal and no specific date has been scheduled for debate.

Agendas are typically published around a week before meetings take place.

Supporters of the proposal say the move is about ethical investing and ensuring public money is not linked to conflict or alleged human rights abuses.

One campaign supporter said: “Residents don’t want their pensions invested in companies that profit from war. Councils already take ethical positions on fossil fuels and arms manufacturing – this is the same principle.”

But others argue that foreign policy issues fall outside local government’s remit and warn the move could affect pension performance.

Sharon Ross, a freelance writer who contacted The Herald ahead of the debate, said councillors should focus on local services instead.

She said: “Local issues where councillors can make a real difference – roads, schools, GP access and business support – risk being pushed aside for international politics.

“Divesting from an entire country could reduce diversification and potentially lower returns for pension holders without achieving meaningful change overseas.”

Local government pension schemes operate under fiduciary duties requiring investments to prioritise members’ financial interests. Previous legal guidance to councils across the UK has stressed that decisions must be based primarily on financial considerations.

The Herald has asked the council to confirm when the petition will be scheduled, what proportion of the pension fund might be affected, and what financial or legal advice members will receive.

Residents can monitor the authority’s “Agenda, Minutes and Decisions” webpage for the publication of the next Full Council agenda, where the item is expected to appear once formally listed.

Further updates will follow when a date is confirmed.

 

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Crime

Shoplifting down in Wales on paper – but local retailers say reality feels different

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Police figures show recorded thefts falling locally, while shopkeepers and former offender describe ‘daily’ losses and low reporting rates

POLICE statistics suggest shoplifting is falling across Wales – but retailers in Pembrokeshire have told The Herald the problem remains persistent, under-reported and, in some cases, worse than ever.

Figures from the Office for National Statistics show a 10% decrease in police-recorded shoplifting across Wales in the year to September. In the Dyfed-Powys Police area, which covers Pembrokeshire, recorded offences fell by 20%.

The numbers were welcomed this week by retail union Usdaw, which said the drop offered “hope” that government action on retail crime was starting to have an effect.

However, several local traders said the official figures do not reflect what they are seeing on the ground.

One Milford Haven shopkeeper, who asked not to be named, told The Herald: “We don’t always report it now. You’d spend half your day on the phone. Sometimes it’s easier just to write it off. But it’s happening all the time.”

Another said theft had become “a daily nuisance”, adding that repeat offenders often returned within days.

Under-reporting concerns

The gap between statistics and experience may be explained by the way crimes are recorded.

Police figures only count incidents that are reported and logged. Retailers say many low-value thefts go unreported due to time pressures, lack of confidence that action will follow, and the administrative burden of statements and CCTV downloads.

Usdaw’s own survey of nearly 9,500 shop workers found that more than three-quarters had experienced verbal abuse, while over half had been threatened – with many incidents linked to theft.

Former offender speaks out

The Herald also spoke to a man from Milford Haven who was recently released from prison after serving time for repeated theft offences.

He said he had spent more than two years funding a drug habit by shoplifting across Pembrokeshire and in Cardiff.

According to his account, it was possible to steal goods worth up to £1,000 a day and sell them on, and he was “rarely stopped”.

“Most of the time you just walk out,” he claimed. “Even if staff catch you, they don’t always call police. It’s not worth their time.”

He said he had been detained around 50 times during what he described as hundreds of incidents, but only about ten led to police involvement and just four resulted in court.

While his experience is anecdotal, it echoes the frustrations voiced by local businesses who believe many thefts never make it into official statistics.

Government crackdown

The issue has also been raised in Parliament.

Pembrokeshire MP Henry Tufnell has previously said he has spoken to local shop owners about the impact of retail crime and has welcomed government measures aimed at strengthening enforcement.

Labour has pledged tougher action on shoplifting, including ending the widely criticised £200 threshold that many retailers felt led to low-value thefts being deprioritised, alongside promises of more visible neighbourhood policing.

Retailers say any extra support would be welcome – but many believe rebuilding confidence that crimes will be taken seriously is key.

As one trader put it: “The stats might say it’s down. But if you’re running a small shop and losing stock every week, it doesn’t feel like it.”

 

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Community

Princess of Wales praised for ‘skill’ during local wool mill and factory visit

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Royal tour shines spotlight on west Wales textile heritage and local jobs

CATHERINE, Princess of Wales was told “she’s got the skill” after trying her hand at traditional textile work during a visit to west Wales on Tuesday (Feb 3).

The royal spent the day meeting staff and apprentices at two well-known manufacturers – Melin Tregwynt in Pembrokeshire and Hiut Denim in Cardigan – highlighting the region’s long-standing reputation for craftsmanship and small-scale, high-quality production.

Stitching and mending at historic mill

At Melin Tregwynt, a family-run woollen mill that now operates as an employee-owned trust, the princess was guided through each stage of production, from weaving to finishing.

In the quality control room she was invited to mend a blanket using a needle and thread, carefully repairing the fabric under the watchful eye of experienced staff.

Paula Harding, who has worked at the mill for more than a decade, praised her technique, saying: “She did it right – and she didn’t go through the other side. That’s skill. She’s got the skill.”

Laughing, the princess told workers: “You make it look so easy,” adding that the craft was clearly “a labour of love”.

She asked questions about the history of the business, which has produced Welsh-designed blankets and throws for more than a century, and spoke with several generations of the same families who have worked at the mill.

‘Made in Wales’ denim

Later, the princess travelled to Hiut Denim, the Cardigan-based firm credited with bringing jeans manufacturing back to the town after large factories closed in the early 2000s.

The company now focuses on small-batch, premium denim and employs skilled cutters and machinists locally.

During a tour of the factory floor, the princess tried cutting out a pair of jeans and helped stitch a “Made in Wales” label onto a finished pair that staff said would be presented to the Prince of Wales.

“He will love those,” she replied.

She joked that there was “no pressure” when handed the cutting tools and said she enjoys making clothes herself, admitting the most adventurous project she had attempted was sewing a pair of pyjamas.

The royal also stopped to greet Barney, the factory’s English cocker spaniel, drawing smiles from staff.

Meeting well-wishers

Crowds gathered outside both sites to catch a glimpse of the visitor, with the princess spending time chatting with families and children before moving on.

The visit forms part of ongoing efforts by the royal household to showcase traditional industries and skilled manufacturing across the UK, with west Wales’ textile sector recognised as a key part of the region’s heritage and economy.

For workers at both businesses, the message was simple: the spotlight on locally made products and homegrown skills was just as important as the royal presence itself.

Local flavour: The Princess of Wales chats with staff and accepts a jar of Crwst’s Welsh honey butter before departing Cardigan following her visit to Hiut Denim (Pic: Crwst).

 

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