News

GP shortage in Wales: Patients per doctor double European average

Published

12 months ago

February 13, 2025

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..

Crime

Man charged with attempted murder after Carmarthen park incident

Published

5 hours ago

February 4, 2026

Tom Sinclair

57-year-old due in court following alleged knife and stalking offences

A MAN has been charged with attempted murder following a serious incident in Carmarthen town centre last week.

Dyfed-Powys Police confirmed that James McKenna, aged 57, from Carmarthen, has been charged with attempted murder, possession of a bladed article in a public place, and stalking.

The charges relate to an incident in Carmarthen Park on Thursday (Jan 29), which prompted a significant emergency services response and caused concern among residents.

Police have not yet released full details of the circumstances, but officers were seen in and around the park area for several hours following the incident while enquiries were carried out.

McKenna is due to appear before Llanelli Magistrates Court on Thursday (Feb 5).

The Herald understands the case involves allegations of both violence and targeted behaviour towards an individual, with stalking listed among the charges.

Public concern

Carmarthen Park is a popular and busy public space used daily by families, dog walkers and joggers, and incidents of this severity are rare.

The news has prompted concern locally, particularly as the alleged offences include possession of a knife in a public place.

Residents have previously raised questions about safety in parks and open spaces across west Wales, especially during darker winter evenings.

Court proceedings

At this stage, the charges remain allegations and the case will now proceed through the courts.

Magistrates will decide whether the case is sent to Crown Court due to the seriousness of the attempted murder charge.

Further details are expected to emerge during Thursday’s hearing.

The Herald will be attending court and will provide updates as they become available.

Crime

Sex offender jailed after living off grid in Pembrokeshire and refusing to register

Published

5 hours ago

February 4, 2026

Court Reporter

Man walked into police station after months avoiding authorities

A CONVICTED sex offender who told police he intended to live “off grid” rather than comply with legal monitoring rules has been jailed after handing himself in at a Pembrokeshire police station.

Christopher Spelman, aged 66, of no fixed address, appeared for sentence at Swansea Crown Court after admitting breaching the notification requirements of the sex offenders register.

The court heard Spelman was released from prison in Dorset on July 4 last year but immediately refused to provide police with an address, despite being legally required to do so within three days.

Instead, he indicated he planned to buy a tent and live outdoors.

Prosecutor Brian Simpson said officers subsequently launched a nationwide search when Spelman failed to make contact with police. Public appeals were issued and his case featured on the television programme Crimewatch.

Detectives believed he had been travelling around the UK using public transport and staying at campsites. He was known to have links to several areas including Merseyside, Manchester, Devon, Cornwall and Hampshire.

His whereabouts remained unknown until January 3 this year, when he walked into Haverfordwest police station and was arrested. It is unclear how long he had been in Pembrokeshire.

Spelman previously served seven years in prison after being convicted in 2014 of 12 counts of sexually assaulting a girl under the age of 14. He was placed on the sex offenders register for life.

The court heard this was not the first time he had failed to comply with the rules. After an earlier release in 2016, he again failed to register his address and avoided police for around five years before being caught.

He has 11 previous convictions for 29 offences.

Defence barrister Andrew Evans described the case as unusual and said his client had long disputed his original conviction and had expressed a wish to live “outside society”.

However, he said Spelman had gradually accepted that he remained subject to court orders and now wanted more stable accommodation and a chance to rebuild his life. The defendant asked the court to impose a custodial sentence so arrangements could be made for his future release.

Judge Geraint Walters noted there were signs Spelman wished to change but warned that any further breaches would result in longer prison terms.

With credit for his guilty plea, Spelman was sentenced to 10 months in prison. He will serve up to half in custody before being released on licence.

Crime

Former Wales rugby star admits Christmas Day drink-driving offence

Published

11 hours ago

February 4, 2026

Sarah-Jane Absalom

Ex-Ospreys captain was almost twice over limit in Pembroke town centre

Former Wales back row Jonathan Thomas has admitted driving through Pembroke town centre on Christmas Day when he was almost twice over the drink-drive limit.

This week Haverfordwest magistrates heard that Thomas, 43, was stopped by officers as he drove his Mercedes CLA 220 along The Green, Pembroke, at around 5pm on Christmas Day.

“The officers were very concerned at the manner of his driving, as the car was being driven erratically and was swerving to the other side of the road,” said Crown Prosecutor Sian Vaughan.

“When Jonathan Thomas got out of the car, the officers could see that he was having difficulty standing and was unsteady on his feet.”

Subsequent breathalyser tests showed Thomas had 62 mcg of alcohol in his system, the legal limit being 35.

Thomas, who has no previous convictions, pleaded guilty to the drink-drive charge and was represented in court by solicitor Jess Hill.

“He has family in the area and had travelled to spend time with them on Christmas Day,” she told the magistrates. “He’s very remorseful for his actions and hugely regrets his decision that day.”

Jess Hill concluded by saying that Thomas is currently “between jobs and living off his savings”.

Thomas, who gave his address as Main Road, Bredon, was disqualified from driving for a total of 18 months.

“The length of your disqualification reflects the fact that you were more than a little bit over the limit,” commented the presiding magistrates when imposing sentence.

He was fined £120 and ordered to pay £85 costs and a £48 court surcharge.

The former Wales back row left his role as Swansea RFC head coach at the beginning of December 2025 as a result of ongoing health concerns. He was forced to retire from playing in 2015 on medical advice after being diagnosed with epilepsy and is one of the 390 former rugby union players currently taking part in a concussion lawsuit against the sport’s authorities.

“Long-standing issues linked to the head trauma have caused me some concern recently and it has been impossible for me to give the role everything it needs,” he said in a previous interview with the BBC.

His rugby career started out with Pembroke RFC juniors before moving to Swansea RFC, which he captained when he was 19. He then joined the Ospreys where, over a ten-year period, he won four league titles and an Anglo-Welsh Cup. He was the youngest player to captain the Ospreys and, at the time of leaving, was the joint highest appearance holder, together with Andrew Bishop, on 188 appearances.

His international career saw him play for Wales at Under-16, Youth, Under-19, Under-21 and Sevens levels. He made his senior international debut against Australia in 2003, featured at the 2007 Rugby World Cup and was part of two Six Nations Grand Slam-winning sides in 2005 and 2008. Between 2004 and 2011, Thomas was included in every Wales Six Nations squad. In his appearances for Wales, he scored seven tries.