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The NHS at 75: Urgent national dialogue required to address future healthcare needs

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AS THE NATION celebrates the 75th anniversary of the NHS, the Welsh NHS Confederation has called upon the Welsh and UK Governments to engage in a comprehensive national conversation regarding the innovation and transformation of the health and care system. In a press release, the Welsh NHS Confederation emphasised the need to adapt to meet the requirements of future generations.

On Wednesday, 5th July, the Welsh NHS Confederation will present a report at the Senedd, signalling the commencement of a public debate on the future of healthcare and care services. The organisation acknowledges the public’s enduring trust in the NHS and its fundamental principles of providing free care to all in need. However, it is widely recognised that the existing health and care services are unsustainable. Over the past 75 years, the demographics of the population have undergone significant changes, with substantial improvements in life expectancy for both men and women in England and Wales, an achievement to be celebrated.

Nevertheless, the challenges posed by an ageing population with increased frailty and chronic conditions necessitate a thorough re-evaluation of health and social care. The NHS is confronted with mounting demands while simultaneously contending with immediate pressures that impede long-term planning for health and care services.

This pivotal moment calls for collaborative efforts to co-produce and redesign services, ensuring they effectively adapt to the evolving needs of the population and remain sustainable in the future. Crucially, the NHS must empower individuals to make informed decisions about their own well-being and independence, guaranteeing access to the most appropriate care for their specific requirements.

It is vital to recognise that access to healthcare represents only a fraction of a population’s overall health, with socio-economic factors playing a substantial role. Wales, for instance, faces the highest poverty rate among the four nations of the UK, with more than one-third of children (34 per cent) living in poverty.

The Welsh population grapples with a multitude of health challenges that hinder life expectancy and widen inequalities, many of which lie beyond the direct purview of the NHS. Improving population health and well-being necessitates an integrated approach that encompasses services and sectors beyond healthcare. Redirecting resources towards long-term investment in public engagement and communication, as well as implementing preventative measures across sectors such as housing, education, transport, and access to the arts and leisure, is imperative. All sectors bear responsibility for creating a preventive model, fostering an economic, social, and natural environment in Wales that supports good health and well-being throughout one’s life.

Continuing along the current trajectory is not an option; change is needed urgently. A transparent and candid conversation with the public about the future of health and care services is essential. This discussion must revolve around an NHS that receives adequate and sustainable funding, an NHS that delivers care and prevention directly to individuals and communities, an NHS that empowers and enables, and one that benefits from improvements in public health. The foundation of this dialogue must be an ambitious and sincere partnership between the NHS and the people it serves.

Darren Hughes, Director of the Welsh NHS Confederation, expressed the importance of adapting to opportunities and challenges, a characteristic deeply ingrained in the NHS’s history. He acknowledged the invaluable contributions of NHS staff, social care staff, volunteers, third-sector organisations, unpaid carers, and communities in supporting the nation’s health and well-being. However, Hughes cautioned that the existing efforts alone are insufficient to ensure the long-term sustainability of health and care services for future generations. He emphasised the urgency of engaging in a national conversation to unite behind a shared vision for the NHS’s future. Hughes highlighted that the responsibility lies with the population and all sectors

Charity

Women take on Three Peaks Challenge to support mental health services

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TEN inspirational women are set to tackle the iconic National Three Peaks Challenge on June 7, 2025, to raise vital funds for PATH – Pembrokeshire Action for the Homeless.

Motivated by the support they received through free counselling provided by Pathway Counselling, these women are embarking on this ambitious challenge to help fund mental health services offered by the charity.

The gruelling challenge, organised by Lucy Brazier with the support of Aspire Fitness and Charlotte Neill, will see the group climb the three highest peaks in the UK – Ben Nevis in Scotland (1,345m), Scafell Pike in England (978m), and Snowdon in Wales (1,085m) – all within a 24-hour timeframe. In total, the event involves 23 miles of walking and 450 miles of driving between the mountains.

Lucy Brazier, the organiser, expressed the group’s determination to succeed in this challenge, stating: “We are doing this to give back to the services that helped us through difficult times. Mental health support is crucial, and we hope our efforts will make a difference to others who need help.”

The challenge is not just a test of physical endurance but also a significant fundraising effort. Donations can be made through the group’s JustGiving page at www.justgiving.com/page/nationalthreepeaks.

PATH has been instrumental in supporting individuals struggling with homelessness and mental health issues across Pembrokeshire. The funds raised will ensure the continuation of essential services that positively impact lives.

The team is calling on the community to rally behind them and support their mission. Every donation, no matter how small, will help them reach their goal and make a difference.

For more updates on the challenge and to show your support, visit the JustGiving page and follow PATH’s social media channels.

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Health

Welsh Government ‘utterly failing’ on waiting lists

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PLAID CYMRU has called for action to tackle the NHS backlog, accusing Labour of “utterly failing” and leaving more than 620,000 people languishing on long waiting lists.

Mabon ap Gwynfor, the party’s shadow health secretary, warned waiting lists have hit record highs in every month since March, including each month of the First Minister’s time in office.

He said: “And what’s been the response of this [Welsh] Government? Firstly, to blame everybody else: blame the patients, blame health managers, blame royal colleges, blame everybody and deny responsibility.

“After 25 years of governing, they decided to go on a listening exercise and hear people telling them what they should have known years ago.

“Then, each month leading up to Christmas, a new strategy was put in place, and each month, the numbers on waiting lists were increasing.”

Plaid Cymru MS Mabon ap Gwynfor
Mabon ap Gwynfor, Plaid Cymru’s health, social care and housing spokesperson

Leading a Plaid Cymru debate, Mr ap Gwynfor pointed to his party’s five-point plan to tackle NHS waiting lists which was unveiled this week.

His colleague Sioned Williams raised the “alarming” rise of the use of private health care, warning deep-rooted inequalities are becoming increasingly stark.

Accusing Labour of eroding Aneurin Bevan’s vision for the NHS, she said statistics show a 77% rise in admissions to private hospitals in Wales over five years.

Ms Williams added: “58% of Welsh people have either accessed private health care or know friends or family who have done so, which is higher than the UK average.”

Llŷr Gruffydd, a fellow Plaid Cymru Senedd Member, said: “Now, the situation in north Wales, in my region, is frightening, if I’m honest…. There is a whole generation of children and young people with conditions such as ADHD and autism being let down.”

James Evans, the Conservatives’ shadow health secretary, warned the NHS is in crisis, with more than 23,000 people waiting at least two years for treatment.

“This isn’t just inefficiency,” he said. “It’s a symptom of a deeper problem and the chronic underfunding and neglect of our social care system.”

Mr Evans called for an independent review of NHS Wales to “fix a system that has been broken by years of Labour mismanagement”.

Conservative MS James Evans
Conservative shadow health secretary James Evans

Russell George, who chairs the Senedd’s health committee, raised concerns about Powys health board’s “ridiculous” proposals to balance its books.

The Tory said: “In Shrewsbury or Telford hospital, a Welsh patient could be sitting talking to a consultant and the consultant tells them, ‘We’ve got capacity to see you. We would see you if you were an English patient but we’re not able to because Powys is not able to pay.’”

Labour’s Buffy Williams said years of chronic underfunding from successive Conservative UK Governments has been catastrophic for the Welsh NHS.

Jeremy Miles, who was appointed health secretary in September, pointed to signs of progress on the Welsh Government’s priority of reducing the longest waiting times.

Health secretary Jeremy Miles
Health secretary Jeremy Miles

He told the Senedd the number of people waiting more than two years has reduced by two thirds since 2022, with 3% waiting at least two years compared with 10% at the peak.

Mr Miles said: “The health service is making progress despite the increasing demands upon it but there is much more to be done in order to ensure that people are treated sooner.”

Following the debate on January 15, Senedd Members voted 39-11 against the Plaid Cymru motion before the Welsh Government’s amended version was agreed, 26-24.

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Health

Senedd Members criticise ‘appalling’ cancer delays

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SENEDD Members quizzed Wales’ health secretary after a damning report revealed “alarming” shortcomings in cancer services, including a lack of leadership.

James Evans, the Conservatives’ shadow health secretary, said this week’s Audit Wales report laid bare chronic mismanagement of cancer services.

Questioning his opposite number Jeremy Miles, Mr Evans told the Senedd: “This failure has caused widespread confusion and inefficiencies in patient care.

“Despite a staggering 54% real-terms increase in spending on cancer services over the past 13 years, the NHS in Wales continues to miss the target for starting cancer treatment.

“Leadership failures have resulted in shocking delays for patients, with some waiting over 100 days to begin treatment. These delays exacerbate anxiety and lead to poorer survival rates, which are already worse in Wales than any other nation across the UK.”

Conservative MS James Evans
Conservative MS James Evans

He urged the Welsh Government to fix a leadership vacuum, dismantle bureaucratic silos and ensure patients no longer face appalling delays that cost lives.

Mr Miles welcomed the report, recognising the picture painted by the auditor general that too many people are waiting too long for treatments they should be getting faster.

The health secretary said: “It is true to say for a number of cancers in a number of parts of Wales those targets are being met and sometimes being exceeded quite significantly.

“But the overall picture, I accept, is that targets are not being met.”

Mr Evans, who represents Brecon and Radnorshire, warned of workforce planning failures, severe staff shortages, over-reliance on agencies, and recruitment and retention problems.

He said: “These staff shortages are directly delaying cancer diagnosis and treatment, worsening outcomes for patients.

“Despite repeated warnings from organisations like the Wales Cancer Alliance, the Welsh Government has failed to deliver a comprehensive workforce strategy.”

Mr Miles pointed to a 27% increase in workforce numbers, adding that Wales is not the only country to have difficulty recruiting to certain disciplines such as radiology.

The health secretary agreed about the “unsustainable” reliance on agency staff.

Mr Evans added: “There is becoming an outrage in the public about the ballooning number of managers across the NHS compared to frontline health care providers.”

He suggested overall increases in the workforce – from 72,000 to 91,000 between 2014 and 2023 – have not addressed frontline clinical shortages.

“Shockingly, administrative and estate staff have increased by 51% in that time,” he said.

Mr Evans asked: “After 26 years, how can the Labour Welsh Government justify the bloated expansion of administrative roles while patients face unacceptable delays for treatment due to a lack of frontline staff?”

Mr Miles replied: “The member makes an easy point, and a populist point, but the truth is a complex healthcare system requires people who are competent….

“There has been an increase in recruitment to the NHS across all disciplines and all important roles which enable the NHS to be effectively run.”

He added: “A world view which suggests that managers and those running the NHS simply should be taken out of the system, I think, is a very naive perspective.”

Plaid Cymru MS Mabon ap Gwynfor
Plaid Cymru MS Mabon ap Gwynfor

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, also led on the scathing Audit Wales report during health questions on January 15.

He urged the minister to back his party’s proposed reforms of NHS governance.

Mr Miles said November’s report “echoed” a statement he gave in the Senedd and a speech he made two weeks earlier.

He told the chamber: “I was very pleased to see the kind of fresh thinking I was seeking to bring to the challenges which we face was agreed to by Plaid Cymru.

“And I see the same thing in the plan that was published … yesterday in relation to tackling waiting lists.”

Mr ap Gwynfor hit back: “That’s a disappointing response because you seem to be in complete denial about the problems in the health service.”

The Dwyfor Meirionnydd Senedd Member called for a guarantee that a target for 80% of all cancer patients to receive treatment within 62 days by March 2026 will be met.

He warned that the quality and accessibility of health data is “not up to scratch”, with Public Health Wales “fundamentally hamstrung” in its ability to project future demand for services.

He said: “The Wales cancer registry is meant to provide timely data on cancer incidence … but it hasn’t published validated cancer data since 2021, shamefully this means Wales can’t fully take part in essential national cancer audits … nor global studies.”

Mr Miles replied: “We have actually improved the publicly available data and we publish on a monthly basis about 18 pages of cancer treatment statistics, so that they can be scrutinised.

“We do want to improve transparency further.”

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