THE BMA’s deputy chair of Welsh Council issues stark warning about the ‘truly grim’ predicament facing GPs in Wales after years of severe cuts to funding.

Speaking at the BMA’s annual representatives meeting in Belfast, Dr Phil White, who is also a GP in North Wales, accused the Welsh Government of burying their heads in the sand about the crisis facing GPs and the potential impact this will have on an already severely stretched NHS in Wales.

Addressing the BMA’s membership from across the UK he noted the BMA’s strength remarking on its record-high membership figures and the recent progress made by securing ‘three substantial pay offers’ to restore the significant pay loss for doctors working in secondary care in Wales.

Dr White said: “As a union we are stronger than ever, and we will do what it takes to fight for the service we all believe in.”

“Despite this strength and progress made, the predicament facing general practitioners in Wales is truly grim. The service hangs on a precipice, the funding has been slashed and Welsh Government continue to bury their heads in the sand.

“Continuing to ignore the vital role that General Practice plays in the national health service is a grave mistake. My message to Welsh Government is clear. Restore the proportion of the NHS budget which has been cut from General Practice or else it will collapse. If one part of the NHS crumbles, the rest will follow.

“Over the last ten years GPs have been expected to look after 33% more patients while the number of full-time GPs has decreased by 24%, with a fifth of all practices (nearly 100) closing their doors”

He spoke of the risks to patient safety and the personal toll it was taking on GPs with a survey showing that “80% of GPs fear their high workload is detrimental to patient care; morale is low, with many considering their exit.

“Practices are finding ways to stem rising costs – with many reducing existing staff hours or stopping recruitment entirely which all adversely impacts on workload. This is a crisis” he said.

“It is truly shameful, that GP surgeries are expected to run at a deficit, but health boards are simply bailed out by Welsh Government when they overspend” he added.

Referring to BMA Cymru Wales ‘Save our Surgeries’ campaign Dr White said “the public support for an appropriately resourced service is palpable. In a few short weeks, we gathered nearly 22,000 signatures on our Senedd petition, calling on Welsh Government for a rescue package.

Speaking of the bleak picture in Wales with record-high waiting lists rising he added:

“The NHS has been starved for years. Starved of investment, starved of doctors, starved of beds. The impact on patient care is plain to see. Ambulances queuing outside hospitals, patients deteriorating on waiting lists and patients stuck, waiting to be discharged but unable to move on due to a lack of investment in social care.

“The impact on staff is clear too. The rising workload has become unsustainable and understandably, morale is low.

“Three years ago, we publicly called for significant investment in our health service as well as a radical shake-up to create a seamless service. The NHS, social care and community services must work in partnership to effectively meet the needs of patients. Today, I’m restating those calls – the public is behind us – but are the politicians listening?

Dr White ended his speech noting that doctors would continue to campaign for a better service for patients:

“Rest assured, using our collective drive and strength, we will continue to fight for an NHS which has the resources to enable our profession to deliver the care that the people of Wales deserve.”

• A NEW set of Welsh NHS performance data was released today (Thursday, June 20), and it contains more bad news.

The Welsh Government described the data as “disappointing”.

WG “LACKS GRIP” ON FUNDAMENTALS

Sam Rowlands MS, the Conservatives’ Shadow Health Minister, said: “These atrocious statistics show that the NHS is going backwards under Labour.

“Two-year waiting lists have increased for the first time in two years.

“Keir Starmer has called Labour-run Wales his blueprint for what a UK Labour Government would look like: these figures are a stark warning for the whole UK.”

Mabon ap Gwynfor MS, Plaid Cymru’s health spokesperson, said: “Labour’s complete mismanagement of the NHS in Wales has left us with waiting lists at the highest on record, targets for diagnosis and treatment are being consistently missed, and people are getting stranded in A&E departments for hours on end.

“It’s no wonder that we have such astronomical waiting times when the government has failed to deal with problems in primary care and social care.

“Until the government gets to grip with these fundamental problems, then waiting lists will continue to climb.”

A Welsh Government spokesperson said: “We have made it a priority to reduce long waiting times, and today, the Cabinet Secretary for Health met with health board chairs to instruct them to redouble their efforts to tackle these.

“These figures show the NHS is continuing to manage incredible demand for urgent and emergency care – the number of immediately life-threatening 999 calls in May was 25% higher than the previous year, and demand is nearly two-and-a-half times higher than pre-pandemic levels.”

THE LOCAL PICTURE: HOSPITALS

Over 30% of patients waiting to start treatment in the Hywel Dda UHB area have been waiting for over 36 weeks.

The Health Board has the second-highest proportion of the population waiting to start therapy. In practical terms, that means that around 4,000 people are yet to get the therapy they need.

The number of patients told they did not have it fell. However, the number of patients starting treatment has remained stable for years.

With rising demand for cancer diagnosis and treatment and no improvement in the numbers starting treatment, performance against the target for treating cancer dropped.

At least 75% of patients should start treatment within 62 days of first being suspected of cancer.

Only 42% of cancer patients in the Hywel Dda UHB area started treatment within the target time. To meet a revised target of 80% by 2026, Hywel Dda UHB will have to increase its performance by almost 100%.

The Welsh Government’s performance target for patients waiting to start treatment for less than 26 weeks is 95%.

No Health Board is close to meeting that target, although Hywel Dda UHB is the second-best performer—just over 50% of patients start treatment within six months.

Despite a dramatic fall in the number of inpatient beds in Hywel Dda UHB’s hospitals over the last six years, the number of inpatient admissions rose sharply in April, placing even greater pressure on chronically overstretched staff and resources.

THE LOCAL PICTURE: AMBULANCES

The percentage of red emergency calls being met within eight minutes fell across Wales.

The ambulance performance target is for 65% of all red calls to be attended to within eight minutes.

Across Wales in May, there were 5,110 red (life-threatening) calls to the ambulance service, 13.9% of all calls.

45.8% of red calls received an emergency response within eight minutes, 2.2 percentage points lower than in April.

In the Hywel Dda UHB area, 47.6% of red calls received an emergency response within 8 minutes, compared to a sharply reduced number of calls in the red category.

Examining more detailed data for the Hywel Dda UHB area demonstrates the pressure on emergency hospital admissions and the knock-on effect on the ambulance service.

When an ambulance takes a patient to hospital, admission is supposed to take place within 15 minutes of arrival, with the ambulance returning to service 15 minutes after that.

In the Hywel Dda UHB area, ambulances were tied up beyond those markers for almost 4,000 hours beyond expected admission and return to on-call.

Fewer than 18% of patients conveyed to a Major Injury Department were admitted within 15 minutes. For Major Acute Units, that turnaround was even worse, at barely 15.5%.

Once cleared, however, well over 80% of ambulances were back out on call.

Diving deeper into the data, we see that just over 1,700 patients travelled by ambulance to major emergency, major acute, and maternity and mental health units.

By a very crude piece of arithmetic, we can calculate that if those 1700 patients accounted for the 4000 hours of “lost time”, the handover stats would be even more shocking, with an average turnover of over two hours.

Moreover, localised data shows that 35.6% of all people who are attended by an ambulance go to a hospital using other means of transport.

A CRISIS ACROSS THE BOARD

The issue could not be clearer: delays at hospitals are keeping ambulances off the road.

The upward pressure on A&E services caused by the collapse of out-of-hours primary care (GPs, etc) is driving up attendance at all hospital A&Es.

The lack of beds is driving up a backlog of treatment. The lack of clinical staff means more junior staff fulfil tasks -including initial diagnoses- formerly taken by clinicians and registered nurses. Consolidating rural services on an urban model is making things worse.

Whatever the cure for the disastrous condition of the Welsh NHS, money will not be enough to turn around decades of decline.

THE LATEST NHS performance data for April and May 2024 reveals a troubling picture for healthcare services in Wales. The Welsh Government has acknowledged the disappointing figures, highlighting a growing backlog of long waits for treatment and increasing emergency demands. Despite efforts to tackle these issues, the healthcare system continues to face significant challenges.

The data shows an increase in the overall waiting list for NHS services, marking a reversal after 24 months of consecutive falls. Notably, the number of people waiting more than two years for treatment has risen. The Welsh Government attributes part of this increase to reduced activity during the Easter holidays, but the overarching issue remains high demand.

April witnessed the second highest average daily new referrals on record, putting additional strain on the system. Emergency services are also feeling the pressure, with May seeing over 36,600 emergency calls to the ambulance service, averaging 1,182 calls per day. This marks a 2.6% increase compared to the same month last year and includes a significant rise in immediately life-threatening calls.

Cancer treatment statistics present a mixed picture. While more people started their first definitive cancer treatment in April than in March, the overall delivery against cancer targets has declined. This inconsistency is concerning for patients and healthcare providers alike.

Glenn Page, Policy and Public Affairs Manager for Macmillan Cancer Support, criticised the ongoing delays in cancer treatment. “Far too many people living with cancer are still facing devastating treatment delays, and hardworking healthcare professionals are struggling to stay afloat in a system that simply cannot cope,” he said.

The statistics paint a stark picture: in April 2024, over 800 cancer patients in Wales waited more than 62 days to start treatment, nearly half of all those who began treatment that month. Performance in April was the worst in the past four years, continuing a worrying trend highlighted by Macmillan’s recent analysis that 2023 was the worst year on record for cancer waiting times in Wales.

Ailsa Guard, a breast cancer patient from Swansea, shared her harrowing experience of delays and confusion in her treatment journey. Diagnosed in 2021, she waited 141 days to start treatment and has faced continual setbacks. “I have had to push and fight at every stage,” she said. “Without my determination, I seriously believe I would have been lost to the system.”

The Welsh Government has emphasised its commitment to reducing long waits and improving cancer care. A spokesperson stated that new services have been funded to help keep people out of hospitals, contributing to a 2.3% decrease in emergency admissions in May. The government also hopes that upcoming votes by junior doctors, consultants, and SAS doctors to accept recent pay offers will help stabilise the situation.

Darren Hughes, director of the Welsh NHS Confederation, stressed the need for long-term solutions and investments. “The NHS cannot deliver effectively for all patients when things continue to run so hot. We need commitments from governments to longer-term thinking, including focusing on prevention, shifting more care into the community, and capital investment to make NHS estates more efficient,” he said.

As the NHS in Wales grapples with unprecedented levels of demand, the call for sustained investment and systemic changes is becoming increasingly urgent. Healthcare leaders and patient advocates alike are urging the Welsh Government to take decisive action to ensure that the NHS can provide timely and effective care for all its patients.