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Health

Welsh Government considers abandoning ‘ill-advised’ cancer target

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A KEY ambition for 80% of cancer patients to start treatment within 62 days could be dropped because services have little chance of hitting the target, a committee heard.

Eluned Morgan, Wales’ First Minister, announced plans to raise the performance target from 75% to 80% by 2026 while she was health secretary in 2022.

But, appearing before the Senedd’s public accounts committee today, NHS Wales deputy chief executive Nick Wood suggested the 80% target could be scrapped.

“I think we need to reflect on experience and what’s happened in the years since,” he said.

Mr Wood pointed to a report on NHS performance published on Monday following a review by an advisory group which was appointed by the Welsh Government.

He said: “I think some of their recommendations are helpful in terms of stating at this point that it’s probably ill-advised to move the target to 80% when there isn’t really a realistic proposition of us getting to 80% over the next 12 months.”

The so-called single cancer pathway – which was introduced in 2019, replacing the urgent and non-urgent pathways – runs from first suspicion of cancer to the start of treatment.

None of Wales’ seven health boards have hit the 75% target since August 2020 and latest statistics for February showed 60% started treatment within 62 days.

Mr Wood added: “A continued focus on getting to 70% then 75% would be a more advisable approach. We’ve not made a formal decision in terms of stepping away from that 80%….

“I think it would be fair to say that we need to review that position and focus on continuous improvement from the current position of 60%… before we consider going further.”

The 80% target was described by the report as an example of ministers “reaching for new policies or initiatives in preference to focusing on delivery of existing plans”.

Baroness Morgan said at the time: “By 2026, 80% of people who receive a cancer diagnosis should start first definitive treatment within 62 days from the first point when cancer was suspected. We will make sure that those with the greatest need are seen first.”

First Minister Eluned Morgan
First Minister Eluned Morgan

The Conservatives described the 80% aim as not ambitious enough while Plaid Cymru pointed out services were failing to hit the 75% target even before the pandemic.

Ministers accepted all the report’s recommendations, at least “in part”, in its response which set out a focus on skin, breast, lower gastrointestinal, gynaecological and urological cancers.

Mark Isherwood, who chairs the public accounts committee, pressed witnesses on the failure to meet the existing 75% target during the meeting on May 1.

Mr Wood described the performance as clearly unacceptable, adding: “The target is very challenging but it doesn’t necessarily reflect the experience of a huge number of people who are on the cancer pathway. It only reflects those who go through and have treatment.”

Mr Wood told the committee more than 13,000 people in Wales were told they did not have cancer in February. “They would have all been on the cancer pathway at some point but are not part of the performance element of 62 days,” he said.

Pointing to consistent increases in referrals, he added: “It’s unacceptable that we’re only on 60% but there is a lot more below the headline figure which I think is important.”

He welcomed an Audit Wales report which found a lack of national leadership, saying: “We accept the recommendations and would recognise the issues… described within the report.”

Asked whether the existing target is realistic considering rising demand, Mr Wood stressed the importance of setting an ambitious aim supported by clinical evidence.

Tom Crosby, the national cancer clinical director who was involved in establishing the single cancer pathway in 2019, described the policy as the right approach.

The clinical oncologist said: “We must not normalise long waiting times for patients.”

Raising concerns about “unwarranted variation” of services across Wales, Prof Crosby stressed that performance against the target is only one measure of the quality of care.

Labour’s Mike Hedges asked about work to drive improvement in the number of patients being diagnosed early, saying: “Late diagnosis is causing serious problems.

“We know [there are] some cancers where nearly everybody is diagnosed at stage three and stage four – and they have very, very poor survival rates.”

Keith Reid, deputy chief medical officer in the Welsh Government, pointed to the example of the roll-out of bowel cancer screening and proposals for a targeted lung cancer programme.

 

Business

BPCA calls for stronger action to protect Welsh homes from pests

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AHEAD of the Senedd elections in May, British Pest Control Association (BPCA) is calling on the next Welsh Government to do more to protect people in Wales from preventable pest problems in their homes.

In its new manifesto for public health pest management in Wales, the national trade body says no one should have to live with rats, cockroaches, flies or other pests because of poor housing conditions, slow repairs or inadequate waste management. 

Housing, public health and environmental regulation are devolved to the Senedd. 

BPCA is urging Welsh policymakers to make sure protections against pest problems apply to all renters, not just those in social housing. 

The Association warned that pests in homes are not just a nuisance and can pose a risk to health. 

Rodents can spread diseases, including leptospirosis, salmonella and listeria, while also causing damage by gnawing pipes and wiring. Cockroaches, flies, and other insects can spread pathogens, contaminate food and damage belongings. 

Rosina Robson, Chief Exec of the British Pest Control Association (BPCA), said: “Too many people are still being left to deal with pest problems that could and should have been prevented. 

“Where there are building defects, poor waste management or delays to repairs, infestations can quickly take hold. That has a real impact on people’s health, well-being, and quality of life. 

“It should not matter whether someone lives in social housing, private rented housing or temporary accommodation. The risks posed by pests are the same, and the protections should be too. 

“We want the next Welsh Government to recognise the danger pests pose in people’s homes and make sure everyone in Wales has the right to live in a decent home that is protected from avoidable infestations.” 

BPCA’s manifesto calls on the next Welsh Government to: 

  • Recognise the danger that pests pose to the health and well-being of tenants  
  • Ensure protections for all renters, including people living in social rented, private rented and temporary accommodation  
  • Back a stronger public health approach to pest management in Wales.  

The manifesto also highlights the wider role of professional pest management in protecting public health, food supply chains and the built environment across Wales. 

BPCA says tackling pests properly means more than responding once an infestation has taken hold. Landlords and property managers also need to act on the advice of pest professionals, including improving communal waste disposal, repairing defects in buildings and addressing the conditions that allow pests to thrive. 

Niall Gallagher, BPCA’s Technical Manager, added: “We wouldn’t accept pest activity in places such as factories or restaurants where food is prepared, and people should not be expected to put up with the same risks in their own homes. 

“This is about prevention, public health and basic standards. Wales has an opportunity to lead the way and make sure fewer people are left living in misery because of pests.” 

BPCA’s full manifesto, A manifesto for public health pest management in Wales, is available from the Association’s website

 

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Health

Nursing graduate jobs crisis warning as NHS pressures deepen

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THE ROYAL COLLEGE OF NURSING WALES has warned of a growing jobs crisis for newly qualified nurses, saying a shortage of Band 5 posts could leave up to half of this year’s nursing graduates without work when recruitment opens.

The union said the situation was particularly alarming given the severe pressures already facing NHS Wales, with staff continuing to report overcrowded wards, unsafe conditions and unmanageable workloads across multiple health boards.

RCN Wales said the lack of available jobs for newly trained nurses pointed to a serious failure in workforce planning. It warned that losing new entrants to the profession would place even more strain on already overstretched services and could further affect patient care.

The organisation said the situation also undermined the Welsh Government’s and NHS Wales’ duty to improve the quality and safety of care.

RCN Wales is calling on the Welsh Government to provide urgent clarity on the scale of the shortfall, set out credible long-term workforce planning, and introduce immediate system-wide measures to recruit, retain and deploy the nursing workforce Wales needs.

The union said it had received assurances that students would not be penalised if posts were unavailable. That includes being released from any obligation to work in Wales and not being required to repay tuition fee support where workforce shortages prevent them from securing employment.

Professor Sandy Harding, Associate Director of Nursing at RCN Wales, said: “The situation facing newly registered nurses is deeply concerning and exposes serious failures in workforce planning.

“It is becoming increasingly clear that this situation is being driven by financial constraints, including the freezing of vacant posts within local health boards. Our NHS is under intense pressure, yet hundreds of newly qualified nurses may have no posts to enter. This is simply unacceptable.

“These students stepped forward for Wales, trained through immense challenges, and now face uncertainty at the very moment the system needs them most. They deserve far better.

“Every newly qualified nurse will be vital to meeting Wales’s care needs. The RCN will continue to demand transparency, accountability and long-term planning from the system. We will not stop speaking up for students, for our safety-critical nursing workforce, and for the people who rely on safe, high-quality care.”

 

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Health

Crumbling NHS faces £1bn repairs bill in Wales

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Senedd election promises collide with the harsh reality of ageing hospitals, fire safety concerns and a maintenance crisis stretching across the country

WALES’ NHS is facing a repair and maintenance crisis of almost £1bn, with some of the country’s biggest hospitals burdened by ageing buildings, serious safety concerns and growing pressure on already stretched budgets.

New figures covering 210 NHS sites show that the backlog of work classed as high risk or significant risk has now reached £917m — up 71% in just four years.

The data, published for 2024-25 by NHS Wales Shared Services Partnership, shows more than £616m of the total relates to serious problems at 12 of Wales’ 13 main hospitals.

Ysbyty Gwynedd has the biggest backlog of high and significant risk repairs at £110.5m, followed closely by University Hospital of Wales in Cardiff, where the figure stands at £106.8m.

The scale of the problem is not just financial. Three hospitals — Bronglais, Prince Philip and Ysbyty Gwynedd — have 40% or more of their space rated as not fire safety compliant. At Ysbyty Gwynedd, 35% of space is also not regarded as health and safety compliant.

Aging estate

The figures highlight the deep-rooted problem of an ageing NHS estate across Wales.

More than 30 NHS sites have buildings where over half the estate predates the creation of the NHS in 1948. Another 17 sites, including University Hospital of Wales and Bronglais Hospital, are mainly made up of buildings between 50 and 60 years old.

Only one major hospital in Wales — the Grange Hospital near Cwmbran — is said to have no maintenance backlog. But even that project, which cost £350m, was first proposed in 2004 and only opened during the Covid pandemic, showing how long major hospital developments can take.

When the wider risk-adjusted backlog is considered across all NHS buildings in Wales, focusing on problems where safety may be at risk, the total cost rises to more than £1bn.

The largest overall figure is in the Betsi Cadwaladr health board area, where the backlog stands at nearly £278m.

Despite the Grange being one of the newest hospitals in Wales, Aneurin Bevan health board still faces a backlog of almost £233m, much of it linked to older sites including the Royal Gwent and Nevill Hall hospitals.

In Hywel Dda, where hopes of a new west Wales hospital remain some way off, the total backlog has reached £221m. Among the worst affected sites is Glangwili Hospital in Carmarthen, where high and significant risk repairs and maintenance amount to £82m.

West Wales pressure

FOR west Wales, the figures are especially troubling.

Hywel Dda residents have already faced years of uncertainty over the future of hospital services, and the scale of the maintenance bill raises fresh questions about how long ageing buildings can continue to serve local communities safely and effectively.

Bronglais Hospital is among the sites with major fire safety compliance concerns, while Glangwili carries one of the largest repair backlogs in the region.

The growing cost of patching up older hospitals will inevitably intensify the political argument over whether ministers should prioritise maintaining existing buildings or push ahead with long-promised new developments.

The chair of Cardiff and Vale health board recently acknowledged that the age and condition of University Hospital of Wales was affecting morale and efficiency, describing the quality and upkeep of buildings as an ongoing concern.

Expert warning

Mark Dayan, a policy analyst at the Nuffield Trust, said Wales had a worryingly large maintenance backlog by any standard.

He warned that poor infrastructure could directly affect the way care is delivered, making it harder for the NHS to reorganise services, improve patient flow or create safe, modern working environments.

The issue is not unique to Wales. NHS England is facing its own enormous repair backlog, estimated at £16bn. But in Wales, where budgets are tighter and hospital plans often move slowly, the pressure is especially acute.

Election battleground

WITH the Senedd election set for Thursday, May 7, parties are offering different solutions to the growing crisis.

Labour has pledged a £4bn Hospitals of the Future fund, promising new hospitals including replacements for Wrexham Maelor Hospital and University Hospital of Wales, as well as a major development in west Wales.

Plaid Cymru says Labour’s sums do not add up, and argues urgent high-risk repairs should come first.

Reform UK says the Welsh Government should concentrate its capital budget on clearing the maintenance backlog rather than making promises on multiple new hospitals.

The Conservatives say they would declare a health emergency and expand capacity through new community hospitals, diagnostic centres and surgical hubs.

The Liberal Democrats say they would upgrade the worst parts of the NHS estate while backing a replacement for University Hospital of Wales, linking investment to wider reform of social care and community services.

The Green Party has called the backlog a disgrace and says it would launch a multi-year programme to bring NHS facilities up to a safe and modern standard.

Whatever the result in May, the next Welsh Government will inherit a stark reality: before it can deliver a new generation of hospitals, it must first confront the spiralling cost of keeping the current estate from falling further into decline.

 

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