Health

More patients, less funding: ‘inverse workload law’ hitting GPs in poorest areas

Published

4 months ago

November 8, 2025

GP PRACTICES serving the most deprived parts of Wales are under-resourced, overworked and facing collapse despite experiencing the greatest patient need, a committee heard.

Adrian Edwards, a professor at Cardiff University, gave evidence to a Senedd health committee inquiry on the future of general practice today (November 6).

Prof Edwards, who retired from practice in May, reminded Senedd members of the inverse care law – a term coined by Julian Tudor Hart, a GP in Glyncorrwg, Afan valley, in 1971.

It states the availability of good medical care tends to vary inversely with the need for it in the population served, so those who need health care most often have the least access.

Prof Edwards warned the UK is lagging behind other countries, with 45 GPs per 100,000 population compared with Australia (121), Canada (103) and New Zealand (74). He added that Wales was bottom of the UK table, according to latest statistics.

The academic, who was a GP partner for 25 years at a practice which handed back its NHS contract in 2020, said the number of partners has declined every year for a decade.

He told the committee the number of patients per full-time GP has increased in that time, with the total number of consultations also rising since 2019.

Prof Edwards said: “What we also have is an inverse workload law. In the affluent areas of Wales, the average number of patients per GP is 2,100 and in deprived areas it’s 2,400. And, by the way, those practices get 7% less income to provide those services.”

He explained doctors in the poorest areas have more patients to start with, who present about twice as often as those in more affluent areas.

Prof Edwards said the number of GPs has been largely flat since 1947, with resources being funnelled into hospitals “trying to do cure and not doing prevention”. He said the proportion of NHS spending on general practice in Wales has fallen from 11% to 7.6% over 20 years.

He cautioned that focusing on reform of the Carr-Hill formula used to allocate funding to GPs is a zero-sum game: “If you help someone, you’re taking away from someone else.”

Prof Edwards said 10% of GPs aged under 40 left the workforce in 2023, warning: “We’re haemorrhaging, we’ve got to do something about it immediately.”

Deep End Cymru, a network of GPs working to improve care in the most deprived areas, warned practices in less well off parts of Wales are “quietly drowning”.

Jonny Currie, a GP partner at Ringland surgery in Newport, said for every 10% increase in patients from the poorest areas – practice income falls by an average of 1%.

Dr Currie, policy lead at Deep End Cymru, told Senedd members: “We’re looking at tens of thousands less money coming into general practice,” despite greater demand.

Neil James, chair of Deep End Cymru and a GP partner in the Rhymney valley, added: “What we have seen is practices collapsing, going to the wall in many of these areas.”

Dr James, a GP for 22 years who is from Senghenydd, told the committee: “Inverse care has always affected us… having lived and worked in the valleys… you’ve seen societal disintegration and the effects that has on patient health has been profound.”

He pointed to a lack of training practices in poorer areas as a key problem, with GPs so busy at the coalface that they lack capacity. He said his practice faces ‘wall-to-wall deprivation”.

Prof Edwards raised statistics showing 10% of practices in the poorest areas closed or merged, compared with 2.8% elsewhere, over the past three years.

Deep End Cymru’s evidence laid bare the human cost of such inequalities.

The network of 91 GP practices warned women in the most deprived communities spend an average of 16.9 more years living in poor health. For men, the gap is 13.3 years.

Health

Welsh Ambulance Service to host bi-monthly Board meeting

Published

2 days ago

March 13, 2026

Tom Sinclair

THE WELSH AMBULANCE SERVICE is preparing to host its bi-monthly Board meeting – and the public are invited.

Join the meeting on Thursday 26 March via Microsoft Teams to hear senior leaders cover a full agenda, including approval of the Integrated Medium-Term Plan for 2026-29, which outlines what the organisation will prioritise and deliver, how it will use its resources and how it will continue to improve care for the people of Wales over the next three years.

Board members will approve the initial revenue budget for the year ahead and receive an update on current financial performance.

The Board will also hear from Mr Clarke from Cwmbran, who describes an experience of trying to access help via 999 for his late father who was terminally ill.

There will also be an opportunity to pose a question to the Board.

Chair Colin Dennis said: “Board meetings give you the opportunity to really get to know our ambulance service, with a clear view of how important decisions are shaped and the processes behind them.

“They also create a forum to hear directly about ongoing work, explore how we can strengthen support for the Trust’s staff and patients, and connect with the people responsible for shaping those decisions.”

Click here to watch the Board meeting on Thursday 26 March 2026 from 9.30am.

This link will be active from 10 minutes before the meeting starts.

To pre-submit a question, please email [email protected] by no later than Wednesday 25 March 2026.An agenda will be available on the Trust’s website in the days prior to the meeting.

Health

Pharmacies carry out record number of consultations for common health issues

Published

2 days ago

March 13, 2026

Tom Sinclair

PHARMACIES across Wales carried out more than 600,000 clinical consultations for a wide range of common health issues over the last twelve months, according to the latest community pharmacy services statistics.

Almost 346,000 people used the Common Ailments Service, which offers free advice and treatment for twenty-seven common conditions and is available in ninety-nine per cent of pharmacies across Wales.

Figures covering April 2024 to March 2025 show that more than 462,000 Common Ailments Service consultations took place during the period – the highest number ever recorded.

The most frequent reasons people sought help from their local pharmacy included sore throats, hay fever, conjunctivitis and dermatitis.

Pharmacies also carried out more than 53,000 consultations specifically for sore throat treatment, around 33,000 consultations for contraception advice and treatment, and over 121,000 consultations to provide emergency supplies of medicines.

During those emergency consultations pharmacists issued more than 189,000 prescription-only medicines to patients who had run out of medication and were unable to obtain a new prescription in time.

In addition to these consultations, pharmacies across Wales dispensed more than eighty million prescription items over the same twelve-month period.

The Common Ailments Service allows people to receive treatment closer to home while helping free up GP appointments for patients with more complex or urgent medical needs.

Health Secretary Jeremy Miles said: “Community pharmacies play a vital role in providing healthcare across Wales.

“Nearly half a million consultations in a single year shows just how much people value being able to walk into their local pharmacy and get the help they need quickly, without having to wait for a GP appointment.

“We are working to ensure more people can receive convenient care closer to home, and expanding access to these services is a key part of that.

“The right care, in the right place, at the right time — that is what people in Wales want, and what our pharmacies are delivering.”

Community

Lessons from COVID-19 highlight need to strengthen voluntary sector resilience

Published

2 days ago

March 13, 2026

Tom Sinclair

A NEW report has urged the Welsh Government to work more closely with voluntary organisations to ensure communities are better prepared for future emergencies.

The call comes from the Senedd’s Public Accounts and Public Administration Committee, which examined how lessons from the COVID-19 pandemic have shaped Wales’ current emergency planning.

The report highlights the crucial role played by voluntary groups during the pandemic, particularly in supporting vulnerable people and responding quickly to rising community needs.

Clair Swales, Chief Executive of the Powys Association of Voluntary Organisations (PAVO), welcomed the committee’s findings and its recommendation that government bodies strengthen collaboration with the voluntary sector and commissioning organisations.

The recommendation includes making greater use of long-term funding arrangements to support infrastructure investment and improve the sector’s ability to respond to sudden surges in demand during emergencies.

Giving evidence to the committee last November, Swales warned that continued financial pressures across the sector could weaken its ability to respond effectively in future crises.

She said: “If I was asked to bring the third sector together to respond to an emergency at this moment, I could. However, future involvement may become more challenging as the sector continues to face significant financial and capacity pressures.”

The committee’s report, published on Tuesday (Mar 11), explored how the Welsh Government and public bodies responded to the pandemic and what improvements have been made since.

It also considered findings from Module 1 of the UK COVID-19 Inquiry, which examined resilience and preparedness across the UK.

Swales said the report recognises that the work carried out by voluntary organisations during the pandemic came at a significant cost to the sector.

She added: “Evidence from a number of voluntary organisations shows the sector is facing considerable funding and resource challenges.

“We will continue to work with commissioners and the Powys third sector to maximise opportunities, represent the sector’s voice in policy and investment discussions, and ensure rural communities are considered when funding and commissioning services.”