News

GP shortage in Wales: Patients per doctor double European average

Published

10 months ago

February 13, 2025

THE NUMBER of patients per GP in Wales is over twice the European average, raising concerns about primary care availability for hundreds of thousands of patients across the country.

In 2024, a report by BMA Cymru Wales showed that the European average for patients per GP was around 1,000. In Wales, the average is 2,210 patients per full-time GP. Over the last decade, the average number of patients per practice has increased by just under 25%.

RURAL ISSUES

Over the past decade, the number of GP practices in Wales has decreased by 18%, dropping from 470 to 378. This decline is due to a combination of closures and mergers, reflecting broader challenges in general practice, such as workforce shortages and increasing patient demand.

The situation is worsened by the fact that around 80% of Wales’s land area is relatively sparsely populated, consisting of small settlements grouped around former market towns. New GPs are overwhelmingly concentrated in Wales’s few larger urban centres, chiefly along the M4 corridor and the North East Wales border area.

This means rural patients often have to travel significantly longer distances to access GP services compared to urban residents. The closure of rural practices forces patients to register with larger, more distant surgeries, increasing the patient-to-GP ratio. This results in longer waiting times and reduced appointment availability.

Long travel times and a lack of transport deter individuals from seeking timely care, leading to delays in diagnosis and treatment. By the time patients present for clinical care, their conditions may have worsened, making treatment more expensive and reducing the likelihood of positive clinical outcomes.

And that is before patients are placed on one of the NHS’s lengthy waiting lists for diagnosis and treatment.

The older age profile of Wales’s rural GPs was long recognised as a ticking time bomb under primary care. Yet, efforts to stem the outflow of GPs from rural Wales have been patchy and ineffective. Changes to pension rules have accelerated retirements, and as older rural GPs leave the profession, replacing them has become increasingly difficult.

The reasons are clear. Rural Wales faces huge difficulties attracting and retaining GPs due to professional isolation, fewer career development opportunities, and a lack of interest in rural practice partnerships. These factors have led to a reliance on locum doctors or salaried GPs, which in turn can disrupt continuity of care.

IN PEMBROKESHIRE

Practice closures and the shortage of GPs have hit Pembrokeshire hard.

The Argyle Medical Group in Pembroke Dock is the second-largest GP practice in Wales, with around 25,000 patients registered and just nine GPs—an average of 2,800 patients per GP. In 2021, the practice had 10.75 full-time equivalent GPs and was seeking to recruit more. However, due to a lack of available GPs, the practice was forced to withdraw from its Neyland practice at St Clement’s Surgery and reduce hours at St Oswald’s Surgery in Pembroke.

**Argyle Medical in Pembroke Dock has the second-largest GP practice in Wales**

As a knock-on effect of the Neyland closure, patients were transferred to the Neyland and Johnston Medical Practice, which eventually handed back its GP contract following retirements and recruitment difficulties. Its patients are now serviced by salaried and locum GPs employed by the Health Board.

The same issues have plagued GP practices from Tenby in Pembrokeshire’s southeast to St Davids in the northwest. While it would be a stretch to say that “GP deserts” exist in the same way as “NHS dental deserts,” the increasing patient load on hospitals suggests that many people are now seeking treatment at A&E for conditions that would previously have been managed by a GP.

The Welsh Government’s approach is to ask patients to self-triage before going to hospital—an impractical and, for many, heartless solution. If you are a parent with a child in agony and unable to tell you what is wrong, what would you do?

SITUATION NORMAL, SITUATION CRITICAL

In 2018, the Welsh Government announced a plan to recruit 1,000 GPs into NHS general practice in Wales. While the number of GPs has increased, it has not risen by anything close to 1,000. Worse still, the number of full-time GPs has actually fallen.

What this means is that while there are technically more GPs in total, there are fewer available in practice because many of the new recruits work part-time, as locums, or on limited contracts (for example, as doctors on call).

It’s the same statistical sleight of hand used to describe frontline clinical staff in the Welsh NHS. Welsh Government ministers proudly claim that the Welsh NHS employs more people than ever, yet the number of full-time staff has plummeted.

In an attempt to address the GP shortage, the Welsh Government has increased the number of routine clinical assessments and treatments that pharmacists and practice nurses can undertake. However, only seven relatively minor ailments can be treated by pharmacists independently, while practice nurses must have GP approval to prescribe medication.

Expanding community-based healthcare is a sensible aim, but it is undermined by the critical shortage of full-time GPs in rural Wales. There are not enough independent prescribing pharmacists or community nurses to fill the gap. The reliance on locum GPs disrupts continuity of care, leading to situations where patients are taken off long-term medication without explanation or, worse, experiencing increased risks of missed or misdiagnosed conditions.

Wales has reached a tipping point.

Politicians frequently offer warm words about “our NHS,” “our precious NHS,” and “our wonderful NHS nurses and doctors,” but none have publicly acknowledged that the foundation of NHS care—GP surgeries as the first point of contact for the sick—has buckled. If they did, they would have to come up with real solutions instead of blaming patients for being ill or making vague promises about digital medicine transforming rural healthcare.

The situation is critical.

In Wales, that passes for normal..

Entertainment

Gavin & Stacey stars reunite for Christmas advert

Published

1 hour ago

December 4, 2025

Luke Sinclair

Gavin & Stacey favourites Joanna Page and Mathew Horne have reunited on screen for a Christmas special – though not the one fans might have hoped for. Instead of returning to Barry or Billericay, the duo appear together in a new festive advert for Waitrose, sharing a turkey pie while responding to a fan’s heartfelt letter about expressing love through food.

The short film marks their appearance in How to Say It With Food, a six-part series in which Page and Horne tackle some of the nation’s most common Christmas food dilemmas. The clip opens with Page teasingly nodding to their iconic sitcom: “Oh, you didn’t think we’d let Christmas roll around without showing up again, did you?”

Horne quickly follows with his own playful line: “Us? Miss Christmas? Not a chance. But this time we’re here to help you say it with food.”

The pair are then handed an envelope “from Santa”, containing a letter from a viewer asking how he can show his “leading lady” he loves her through food. Mathew quips: “First time saying it, you want a statement. Sixteenth time, you want a statement that doesn’t involve socks.”

He then introduces Waitrose’s new Christmas advert starring Keira Knightley and Joe Wilkinson. The main campaign follows an unlikely festive romance sparked by Sussex Charmer cheese and culminating in Wilkinson presenting Knightley with a turkey pie decorated with the words “I love you”. Watching the moment unfold, Page smiles at Horne and mirrors another classic Gavin & Stacey reference: “Oh, that’s so romantic.”

The duo are soon given their own turkey pie to try. Horne eagerly tucks in before cutting Page a slice, prompting laughter from his co-star. The advert ends with the pair wishing viewers a Merry Christmas as Knightley and Wilkinson share a warm festive kiss on screen.

The reunion comes almost a year after audiences tuned in to the BBC sitcom’s much-anticipated finale, which drew an impressive 12.3 million viewers on Christmas Day. The episode wrapped up storylines including Gwen’s blossoming romance with Dave Coaches, Smithy’s near-wedding to Sonia, and the moment fans had long debated – Smithy and Nessa tying the knot.

Reflecting on the new project, Page said: “You thought you’d seen the last of us! Well, we’re back and what fun we had.” She added: “It was such a treat working with Mat… food is what brings people together over the festive season.”

Horne described the experience as “brilliant”, calling their on-screen reunion “a Christmas tradition”.

Health

Government orders clinical review amid sharp rise in mental health diagnoses

Published

1 hour ago

December 4, 2025

Tom Sinclair

4.4 million working-age people now claiming sickness or incapacity benefit, up by 1.2 million since 2019, many because of a mental health condition

A CLINICAL review into how mental health conditions are diagnosed across the UK is expected to begin this week, following concerns within government over rapidly rising sickness-benefit claims linked to conditions such as autism, ADHD and anxiety.

Health Secretary Wes Streeting has commissioned leading clinical experts to examine whether ordinary emotional distress is being “over-pathologised” and to assess why the number of people receiving sickness and incapacity benefits has grown to 4.4 million – an increase of 1.2 million since 2019.

According to reports in The Times, ministers are particularly alarmed by the surge in the number of 16- to 34-year-olds now out of work because of long-term mental health conditions.

Streeting said he recognised “from personal experience how devastating it can be for people who face poor mental health, have ADHD or autism and can’t get a diagnosis or the right support,” but added that he had also heard from clinicians who say diagnoses are “sharply rising”.

“We must look at this through a strictly clinical lens to get an evidence-based understanding of what we know, what we don’t know, and what these patterns tell us about our mental health system, autism and ADHD services,” he told the newspaper. “That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.”

The review is expected to be chaired by Prof Peter Fonagy, a clinical psychologist at University College London specialising in child mental health, with Sir Simon Wessely, former president of the Royal College of Psychiatrists, acting as vice-chair.

Prof Fonagy said the panel would “examine the evidence with care – from research, from people with lived experience and from clinicians working at the frontline of mental health, autism and ADHD services – to understand, in a grounded way, what is driving rising demand.”

The move comes as the UK Government faces mounting pressure over the rising welfare bill. Ministers earlier this year pulled back from proposed changes to disability benefits, including those affecting people with mental health conditions, after opposition from Labour backbenchers.

Speaking on Monday, the Prime Minister said a fresh round of welfare reform was needed.

Keir Starmer said: “We’ve got to transform it; we also have to confront the reality that our welfare state is trapping people, not just in poverty, but out of work.”

Business

Welsh Govt shifts stance on business rates after pressure from S4C and Herald

Published

15 hours ago

December 3, 2025

Sarah-Jane Absalom

Ministers release unexpected statement 48 hours after widespread concern highlighted in Welsh media

THE WELSH GOVERNMENT has announced a new package of tapered business rates relief for 2026-27, in a move that follows sustained pressure from Welsh media — including S4C Newyddion and The Pembrokeshire Herald — over the impact of revaluation on small businesses.

In Milford Haven, the hard-pressed pub sector is already feeling the impact: the annual bill for The Lord Kitchener is rising from £5,000 to £15,000, while rates at the Kimberley Public House have nearly doubled from £10,500 to £19,500. The Imperial Hall’s rates are increasing from £5,800 to £9,200, prompting director Lee Bridges to question why businesses “are being asked to pay more when we use less services”. In Haverfordwest, the annual rates bill for Eddie’s Nightclub is increasing from £57,000 to £61,500.

A written statement, issued suddenly on Wednesday afternoon, confirms that ministers will introduce a transitional “tapering mechanism” to soften steep increases for tourism, hospitality and small independent operators. Full details will be published with the draft Budget later this month.

The announcement comes less than two days after The Herald’s in-depth reporting brought forward direct concerns from Pembrokeshire business owners and councillors, highlighting the uncertainty facing one of Wales’ most important local industries.

Herald reporting credited by senior councillor

Pembrokeshire County Council Independent Group Leader Cllr Huw Carnhuan Murphy publicly thanked The Herald for pushing the issue into the spotlight.

In a statement shared on Wednesday, Cllr Murphy said: “Welcome news from Welsh Government. Thanks to Tom Sinclair for running this important item in the Herald in relation to the revaluation of businesses and the consequences it will have for many.

He added: “Newyddion S4C hefyd am redeg y stori pwysig yma ynghylch trethi busnes.,” which in English is “and thanks to S4C Newyddion as well for running this important story about business taxes.”

He added that the Independent Group “will always campaign to support our tourism and agriculture industry, on which so many residents rely within Pembrokeshire”.

Media spotlight increased pressure on Cardiff Bay

On Monday, ministers said business rates plans would be outlined “within the next two weeks”.
By Wednesday afternoon — following prominent coverage on S4C and continued pressure from The Herald — Welsh Government released an early written statement outlining new support.

Industry sources told The Herald they believed the level of public concern, amplified by the media, “forced the issue up the agenda much faster than expected”.

A cautious welcome for ‘better than nothing’

Cllr Murphy welcomed the partial support, though he stressed it fell short of what many businesses had hoped for.

“This isn’t the level of support many were hoping for,” he said, “but it is certainly much better than nothing.”

Draft Budget expected soon

The full tapered support scheme will be detailed in the Welsh Government draft Budget, expected within a fortnight.

Tourism and hospitality representatives have reserved final judgment until the figures are published, but many have expressed relief that some support will continue, following weeks of uncertainty.