THE NUMBER of children waiting for an autism or ADHD assessment in Wales could nearly triple to 61,000 over the next two years, a committee heard.

Sarah Murphy, Wales’ mental health minister, told the Senedd’s children’s committee that 20,770 children were waiting for a neurodevelopmental assessment in September 2024.

She said: “The assessment we’ve got from the NHS Executive is that we’re going to see, by March 2027, between 41,000 to 61,000 people waiting for these assessments.”

By comparison, according to freedom of information (FoI) requests, around 4,100 children were awaiting an ADHD or autism assessment in September 2021.

Giving evidence on January 9, Ms Murphy, who is responsible for neurodevelopmental conditions, learning disability, and dementia, pointed to an extra £3m for health boards.

Ms Murphy said: “It will benefit the children and young people who have been waiting the longest and the money then is dependent on the delivery.”

Quizzed by Vaughan Gething, the former First Minister who first brought her into government in May, she suggested the surge in demand was down to increasing awareness.

She added: “That assessment means a lot to children, young people and their families. I was speaking to the National Autistic Society yesterday and they said ‘we’ve raised so much awareness but now we need to ride that wave towards understanding and acceptance’.”

The Conservatives’ Joel James was alarmed to hear waiting lists could almost triple in two years, asking how ministers will intervene to ensure sustainable services.

Ms Murphy replied: “We’ve done a national accelerated design event which was really good. It was over a couple of days: it brought together … everybody who has a part to play in this.

“Because we all recognise that this cannot continue – we have to change.”

Asked whether health boards could expect more funding to drive down waiting lists in future, she said: “No. To be very clear, the £3m is one-off funding.”

Ms Murphy explained health boards are bringing in additional capacity from the private sector in an effort to meet demand but cautioned that this is unsustainable.

The Welsh Government has a target of 80% of children and young people receiving an assessment in 26 weeks, twice as long as the 13 weeks recommended by NICE guidelines.

Yet, while data on waiting times is not routinely published unlike in England, it is thought the 80% target has not been met Wales-wide since it was introduced nearly a decade ago.

Welsh ministers have no corresponding target for adult assessments.

Sixty-seven per cent of children waited at least 26 weeks and 45% waited for more than a year in June 2023, according to the response to another FoI request.

Cwm Taf Morgannwg and Betsi Cadwaladr university health boards currently warn of waiting lists of two and three years, respectively.

Albert Heaney, the chief social care officer for Wales, said health boards are confident an extra 2,000 assessments will be delivered by the end of March.

He said: “Importantly, the money is on condition that they are delivered. It’s coming the other way around on this occasion … it’s not money that’s given out, the money is on delivery.”

Mr Heaney added: “I’m really pleased that there’s a lot of co-production, there’s lived experience, there’s a real energy around this because I think there’s recognition … that it can’t just be about focusing on assessment.”

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.

WALES’ leading doctor Sir Dr Frank Atherton has announced he will stand down after eight and half years as the Welsh Government’s Chief Medical Officer.

Sir Frank has provided independent advice to the Welsh Government on all major issues affecting the health sector in Wales.

During his tenure in Wales, after a previous post in Canada, Sir Frank played a leading role in Wales’ response to the Covid pandemic and has supported the NHS through flu outbreaks and annual winter pressures.

Speaking about Sir Frank’s decision to stand down, Health Secretary Jeremy Miles said: “Sir Frank has provided invaluable advice and guidance, which I am hugely grateful for.

“He played a leading role in our response to the pandemic, ensuring people throughout Wales received valuable information about the virus and about how to keep themselves and their loved ones safe. I wish him all the best for the future.”

Judith Paget, chief executive of NHS Wales, said: “Frank has shown how passionate he is about improving health outcomes for the Welsh population and has led the way on improving the quality of healthcare.

“It has been a privilege to work with him and to have the benefit of his experience and commitment to new approaches.

“He has played a crucial role in being the Welsh voice around the table with other UK Chief Medical Officers, government departments and organisations”

Sir Frank has been responsible for leading the medical profession in Wales and the development of health and care research.

Speaking ahead of leaving his post, Sir Frank said: “It has been a privilege to act as CMO and a highlight of my professional career to have served the people of Wales during this incredibly challenging time.

“I would like to thank all those other civil servants, who have worked tirelessly behind the scenes, who have assisted me for almost a decade in this role.”

Frank Atherton’s successor will be announced in due course.