News

GP shortage in Wales: Patients per doctor double European average

Published

1 year 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..

News

Parties make final push as Wales prepares to vote in historic Senedd election

Published

6 hours ago

May 6, 2026

Tom Sinclair

Campaign leaders criss-cross country in last-minute battle for crucial votes

WALES heads to the polls tomorrow (Thursday, May 7) after a frenetic final day of campaigning that saw party leaders, candidates and activists make one last push to win over undecided voters in what is being described as the most unpredictable Senedd election in modern Welsh history.

With polling stations due to open at 7:00am, parties spent Wednesday targeting key battleground constituencies across the country, including the new Ceredigion Penfro seat, amid growing expectations of a fragmented Senedd and a dramatic shake-up in Welsh politics.

The election is the first to be held under Wales’ new expanded Senedd system, with 96 Members of the Senedd being elected across 16 large constituencies using a proportional closed-list voting system.

Reform UK appeared to finish the campaign with significant momentum following a major rally on Tuesday attended by party leader Nigel Farage. The event drew large crowds and considerable online attention as Reform attempted to convert strong polling figures into seats in Cardiff Bay for the first time.

Farage used the rally to attack both Labour and Plaid Cymru, while positioning Reform as the party of “change” for disillusioned voters. Reform campaigners have focused heavily on immigration, cost of living pressures and opposition to what they describe as “wasteful government spending.”

Plaid Cymru leader Rhun ap Iorwerth spent the final day presenting his party as the main alternative to both Labour and Reform UK, insisting Plaid could “build a fairer Wales” while warning against what he described as “divisive politics.”

Labour figures, including First Minister Eluned Morgan and deputy leader Huw Irranca-Davies, urged voters not to “take risks” with public services, arguing only Welsh Labour could protect the NHS and local councils during a period of economic uncertainty.

Labour activists were heavily focused on turnout operations in traditional strongholds, amid polling suggesting the party could lose ground after decades as the dominant force in Welsh politics.

The Conservatives attempted to rally core voters with warnings about both Labour and Reform, while also focusing on farming, the rural economy and healthcare waiting lists.

In west Wales, Conservative candidates Paul Davies and Sam Kurtz spent the day meeting voters and carrying out final campaign visits across Pembrokeshire and Ceredigion, arguing their experience and local knowledge would be important under the new electoral system.

The Liberal Democrats and Green Party also maintained visible campaigns in several areas, hoping tactical voting and the proportional voting system could help them secure representation.

Across Wales, campaign teams handed out leaflets outside transport hubs, supermarkets and town centres, while social media campaigning intensified throughout the day.

Political analysts believe turnout could prove decisive, particularly because the new voting system means relatively small shifts in support could determine the allocation of the fifth and sixth seats in many constituencies.

The campaign has been dominated by debates over the NHS, farming, the economy, transport, tourism and the rising cost of living, alongside concerns about the future direction of Welsh devolution.

Polling stations open across Wales from 7:00am until 10:00pm on Thursday, with counting due to begin on Friday morning.

The Herald will provide live election coverage online throughout polling day and count day, including updates from count centres, candidate interviews and reaction as results emerge from across west Wales and the rest of the country.

News

Plaid Cymru projected to lead Senedd as Labour faces historic collapse

Published

6 hours ago

May 6, 2026

Tom Sinclair

Final poll suggests Welsh politics could be on the brink of a major realignment

PLAID CYMRU is on course to become the largest party in the Senedd, according to the final YouGov MRP projection for ITV Cymru Wales before polling day.

The model suggests Labour’s century-long dominance of Welsh elections could be coming to an end, with Plaid projected to win 43 seats in the newly expanded 96-member Senedd.

Reform UK is forecast to finish second on 34 seats, while Labour is projected to fall to just 12.

The poll, based on responses from more than 4,600 adults between April 25 and May 4, puts Plaid Cymru on 33% of the vote, ahead of Reform UK on 29%. Labour is on 12%, the Conservatives on 9%, the Greens on 8% and the Liberal Democrats on 6%.

Labour facing major losses

The projection points to a dramatic collapse in Labour support across Wales.

YouGov’s central estimate would represent a notional loss of 32 seats for Labour compared with the 2021 result under the new electoral system.

It would also be Labour’s worst result at any major Welsh election since 1906.

The model suggests Labour may fail to top the poll in any of the 16 new Senedd constituencies, and could return no members at all in four of them.

In west Wales, Labour’s support is projected to have fallen into single figures in some areas.

First Minister Eluned Morgan, who leads Labour’s list in Ceredigion Penfro, could also be at risk if the projection proves accurate.

Reform surge

Reform UK is projected to make major gains, rising from just 1% of the vote in 2021 to 29% in the final pre-election model.

The party’s support appears to be spread widely across Wales, though it is weaker in Cardiff and strongest in parts of the south Wales valleys.

One of the most striking projections is in Pontypridd Cynon Merthyr, which includes the Merthyr Tydfil area where Keir Hardie was elected as Wales’s first Labour MP in 1900.

There, YouGov’s central estimate puts Reform UK narrowly ahead on 34%, Plaid Cymru on 33%, and Labour on 14%.

Smaller parties

The Conservatives are projected to win just four seats, which would be their weakest devolved election result.

That would leave them one short of the five members needed to form an official political group in the Senedd.

The Greens are forecast to enter the Senedd for the first time, winning two seats in Cardiff.

The Liberal Democrats are projected to win one seat in Brycheiniog Tawe Nedd, keeping Jane Dodds in the Senedd.

No majority expected

No party is projected to win the 49 seats needed for an outright majority.

YouGov’s modelling suggests Plaid Cymru would be best placed to lead the next Welsh Government, but would probably need support from another party.

Plaid and Labour together reach a majority in most of the model’s simulations, while a Plaid-Green arrangement does so far less often.

A Reform-Conservative majority appears unlikely in the projection.

Under the new D’Hondt voting system, small movements in vote share could still make a significant difference, particularly for the final seats in each constituency.

Polling stations open tomorrow, Thursday, May 7.