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Health

Welsh cancer care in peril as workforce crisis escalates, warn radiologists

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THE ROYAL College of Radiologists (RCR) has issued a stark warning about the escalating workforce crisis in Wales, revealing alarming shortfalls in clinical radiologists and oncologists.

Two new reports highlight a dire situation: Wales faces a 34% shortfall in clinical radiologists and a 12% shortfall in clinical oncologists. Without immediate action, these shortfalls are projected to rise to 28% and 38%, respectively, by 2028, the largest in the UK. Additionally, nearly a quarter (24%) of clinical oncology consultants in Wales are expected to retire in the next five years, compared to the UK average of 18%. Currently, trainees make up 29% of Wales’s clinical oncology workforce, slightly below the UK average of 32%.

Patient safety is at risk due to the critical shortage of radiologists. Wales has only 6.1 radiologists per 100,000 people, the lowest ratio among the four nations. All clinical directors in Wales report that they lack sufficient radiologists to provide safe and effective patient care. Cancer centres are experiencing routine delays in starting treatment and are struggling to manage increasing demand, relying heavily on goodwill, insourcing, and locums. Such delays are critical for cancer patients, as each month’s delay in treatment raises the risk of death by approximately 10%.

Despite the implementation of the Cancer Improvement Plan for Wales a year ago, the workforce crisis continues to worsen due to insufficient training and retention efforts. Hospitals are struggling to meet patient demand, and this issue is one of the most pressing challenges that the UK governments must address urgently.

The reports also reveal significant regional disparities in access to cancer care across Wales. Rural areas are the hardest hit. South West Wales has 7.4 clinical oncologists per 100,000 older residents, South East Wales has 6.6, but North Wales lags behind with just 5.3. North and West Wales suffer from the UK’s largest shortage of clinical radiologists, with London having twice as many radiologists per 100,000 people. This disparity leads to faster imaging test results and cancer treatment initiation in some regions, causing significant delays and increased anxiety in others.

An anonymous consultant stated, “I can no longer defend the NHS as an exemplary healthcare system. We are all failing and in so doing failing our patients.”

The RCR has written to the cabinet secretary, warning that without immediate intervention, Wales risks undoing decades of progress in cancer care. The RCR demands urgent investment in workforce development to ensure patients are not left waiting for a diagnosis and can begin lifesaving treatment promptly. They urge the next government to collaborate with the NHS to outline a plan to recruit, train, and retain clinical oncologists and radiologists, ensuring workforce stability for future generations.

Dr Katharine Halliday, RCR President, said, “Today’s reports lay bare a harsh reality: the crisis in Wales’ radiology and oncology workforce is jeopardising patient health. Despite our commitment to providing the best care, severe staff shortages are significantly impeding our efforts. We simply do not have enough doctors to safely manage the growing number of patients, and this issue will worsen as demand rises and more doctors leave the NHS. The immense strain on an overburdened system, coupled with exhausted staff and increasing demand, creates a toxic mix for the healthcare system in Wales.

“Urgent action from the governments of all four nations is essential. We must prioritise recruiting and training more doctors and implement strategies to retain our current workforce. Time is critical; doctors are working under extreme stress and are deeply concerned for their patients. We’re calling on the governments of all four nations to reset the system, save our NHS, and ensure that patients receive the quality care they deserve.”

Health

Rising trend of private healthcare use among friends and family in Wales

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MORE than half of UK residents report having close family or friends who have used private healthcare services, according to the latest data from the Independent Healthcare Providers Network (IHPN). In Wales, this figure is 58%, slightly above the UK-wide average of 55%. Meanwhile, 32% of Britons have used private healthcare themselves, with regions such as the East Midlands (64%) and Northern Ireland (59%) showing even higher familiarity with private healthcare options.

David Hare, Chief Executive of IHPN, said: “Private healthcare is becoming more mainstream, with people increasingly opting for private services to access healthcare more easily and quickly. Our findings highlight that most people in the UK know someone close who has used private healthcare, whether through insurance or self-pay. This demonstrates a shift toward private healthcare as a convenient and accessible option.”

Claims that private healthcare is becoming more mainstream in Wales

The survey found that 45% of those choosing private healthcare did so because of long NHS waiting times, while 27% preferred the ease of booking private appointments. Around 20% receive private healthcare through work, and 17% believe private services offer higher-quality care. Accessibility is another key factor, with half of respondents agreeing that private healthcare is more accessible than NHS options.

Top Treatments Accessed Privately:

  • Doctor consultation: 45%
  • Diagnostic treatment (e.g., scans): 45%
  • Other healthcare professional consultations: 35%
  • GP appointments: 34%
  • Minor operations (same-day discharge): 25%
  • Major operations (overnight stay): 16%
  • Ongoing serious condition treatment (e.g., cancer): 5%

IHPN’s Five Steps to Choosing Private Healthcare

If you’re considering private healthcare, IHPN suggests these key steps:

  1. Do Your Research: Consult inspection reports from national care regulators like the Care Quality Commission (CQC) in England and the Private Healthcare Information Network (PHIN). Scotland and Wales have independent inspectorates, available at hiw.org.uk and healthcareimprovementscotland.scot.
  2. Explore Payment Plans: Many providers offer flexible payment options, making private care more affordable.
  3. Find Local Options: Use resources such as ihpn.org.uk or phin.org.uk to locate private providers nearby.
  4. Take Control: It’s your choice; seek recommendations from friends and family or consult online ratings to find the right clinician or clinic. Your GP can also offer support.
  5. Book a Consultation: Before committing, schedule a consultation with a private provider to discuss treatment options and ask questions. Bring someone you trust if you wish, and take notes.

For more information on private healthcare options in the UK, visit ihpn.org.uk. For additional information, interviews, or case studies, contact Helen Trevorrow at 0794 000 9138 or [email protected].

Source: Statistics are from the “Going Private 2024” report by IHPN and Public First, based on a survey of 2,004 respondents across the UK.

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Health

Smoke-free ambitions clouded by concerns over illicit market

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THE UK government introduced its Tobacco and Vapes Bill in Parliament today, aiming to create a “smoke-free generation” by prohibiting anyone born after 1 January 2009 from legally purchasing cigarettes for the rest of their lives. The Bill also proposes strict new restrictions on nicotine products, including vapes, heat-not-burn products, and nicotine pouches.

Public health experts in Wales are largely supportive of the new legislation, seeing it as a potential driver in reducing the strain on the NHS in Wales. Smoking-related illnesses are a major contributor to healthcare costs, and advocates argue that curbing smoking among future generations will yield long-term health and economic benefits. This could be especially impactful in Welsh regions where smoking rates are persistently high.

However, there is also concern about how restrictions on safer nicotine alternatives, such as vapes and heat-not-burn products, could impact Welsh individuals trying to quit smoking. The Welsh NHS has invested in smoking cessation programs that promote these alternatives, and some fear that restrictions on these products may reduce access to effective cessation tools, ultimately affecting health outcomes.

Mike Salem, UK Country Associate for the Consumer Choice Center (CCC), reacted to the news: “Whilst it is predictable that the prohibition was going to be introduced, I am extremely concerned and disappointed with how little regard the government has had for consumers’ voices, particularly the young voices.”

The Bill revives an initiative initially proposed by the previous Conservative government before the election, though Labour’s version brings in tougher regulations. The proposal has sparked debates across various groups, with health advocates supporting the measures and others, like the CCC, voicing concerns about potential unintended consequences.

Illicit market worries

The CCC has highlighted fears that prohibitions may fuel an already significant black market for tobacco products in the UK. According to Salem, 2023 saw the highest number of illicit cigarettes consumed in the country, with one in five cigarettes sold illegally. He warns that restrictions risk expanding this underground market.

“It is no surprise that gangs and illegal suppliers are already positioning themselves in this market in anticipation of the prohibition,” Salem said. He cited experiences from other regions, such as the state of Victoria in Australia, where similar prohibitions have led to gang-related violence and exposed children to criminal activities, including arson.

Impact on young people

Critics of the Bill argue that the Labour Party’s approach may negatively impact young people, whom they claim are already disadvantaged by recent policies. “The Labour Party has shown that it is the Party of Boomers, and is letting young people down,” Salem said. He added that recent increases in tuition fees and levies on alcohol and soft drinks, along with tougher employment markets, restrict young people’s lifestyle choices and increase their exposure to illegal markets.

Public health debate

Supporters of the Bill believe these measures are necessary to protect public health. They argue that strict controls on tobacco and nicotine products are crucial steps towards reducing smoking rates, improving long-term health outcomes, and reducing the burden on the NHS. Advocates also believe that limiting youth exposure to nicotine will reduce future smoking rates.

However, Salem argues that the Bill may have the opposite effect. “Not everyone can quit cold turkey,” he said, noting that many people have found success using alternative products like vapes, heat-not-burn devices, and nicotine pouches. “Restricting safer methods of consuming nicotine makes it extremely difficult for those who are trying hard to quit smoking to do so permanently and positively.”

Alternative solutions proposed

The CCC says it is calling on the government to ensure existing laws are enforced first, such as banning nicotine sales to under-18s, before introducing a total prohibition. They argue that failing to do so will lead to worse public health outcomes and put consumers and children in a vulnerable position. The Bill now moves forward for further debate, with both sides urging careful consideration of the potential impacts on public health, youth, and the illicit market.

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Health

Welsh GP committee reject contract offer and hold referendum for members

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BMA Cymru Wales’ GP committee has voted unanimously to reject the Welsh Government’s offer for the 2024/2025 GMS (General Medical services) contract, as it fails to provide a credible and sustainable future for general practice.

GPs in Wales will now vote on whether to accept or reject the contract in a referendum which will open later this month.*

Dr Gareth Oelmann, chair of the BMA’s Welsh GP committee said:

“The decision to disregard the serious concerns and valuable contribution of general practice once again in Wales is beyond insulting, it is dangerous, leaving more surgeries and their patients in peril.

“We are deeply concerned that this offer will leave more practices with no option but to close their doors. GP practices are being denied the resources they need to deliver vital services to the population.

“For years, the service has been starved of adequate funding which has led to the closure of 100 surgeries since 2012. This is having a devastating impact on general practice.

“A recent survey** of our members showed that 91% of GPs are routinely unable to meet patient demand due to unsustainably high workloads.

“With 100 fewer surgeries for patients to turn to, GPs are now seeing up to 35% more patients each, causing unsustainably high workloads and burnout with doctors being expected to do more with less, risking patient safety. How long can this continue?”

Dr Oelmann continued: “General Practice is the foundation of a high-quality, cost-effective health system, but successive governments have insisted on ignoring the vital role general practice plays in the national health service.

“Welsh Government had an opportunity to change the current trajectory but has failed to do so. It is now up to GPs to decide what happens next.”

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