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Health

‘The future for general practice is grim’: GPs sound alarm about funding crisis

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GENERAL practitioners called for an overhaul of an “outdated, unfair” funding model, warning of an “enormous and growing” inequity putting patient safety at risk.

Doctors gave evidence as the Senedd’s health committee began an inquiry into the future of GPs amid concerns about more than 100 surgeries across Wales shutting since 2012.

James Pink, a GP partner in Llanishen, Cardiff, expressed concerns about the Carr-Hill formula, used to allocate funding to practices, which was designed in the late 1990s.

He said: “There’s almost no correlation between funding and deprivation which beggars belief. And the correlation between age, sex and funding isn’t as clear cut as you’d think.”

Dr Pink told the committee variation across Wales means an average practice could be £862,000 worse off than another similarly looking after 10,000 patients.

Noel McLoughlin, a partner at St Isan Road Surgery in Heath, said his colleague found Cardiff and Vale GPs were the worst-funded in the whole of Wales and England.

Dr McLoughlin wrote to the committee: “This means that the Carr-Hill formula regards Cardiff as the wealthiest and healthiest area with the lowest needs.

“This is clearly nonsense. The inequity in funding in Wales alone is enormous – worse still, it is growing. This must stop or the future for general practice and primary care in Cardiff is grim. No-one will want to work here.”

The GP warned: “All patients in all areas are having difficulty accessing primary care. We are struggling to maintain safe levels of working with the current demand and it is going to rise.”

Kate Baker, another Cardiff GP, wrote: “It has been distressing to see the deterioration in funding and support for general practice over the 17 years I have worked as a GP.

“The partners in our practice have not seen a pay rise for nine years and, in fact, the imposed contract for 2023/24 led to a pay cut.”

Giving evidence on July 10, Richard Stratton, a GP partner in Powys, agreed about the necessity of updating the “unfair” formula but cautioned that it will remain a blunt tool.

Dr Stratton told the health committee: “What we also need to factor in is the supplementary services that general practices participate in on top of the core contract.”

He said: “The combination of a revised formula plus better use of local services… would take us forward enormously. At the moment, both feel hamstrung by budgetary constraints.”

Asked about the system of annual negotiations on the General Medical Services (GMS) contract, Dr Stratton said single-year budgets have a debilitating impact on investment. “Without that ability to plan, everything is crisis management,” he warned.

John Williams, a practice manager in north Wrexham, described the contract process as piecemeal and rushed, criticising “tokenistic” smaller investments for posters and suchlike.

Mr Williams pointed to a “double whammy” on employer national insurance contributions, with no public exemption and no £10,500 employment allowance like private businesses.

He said his 13,000-patient practice also faces a £70,000 or 20% overnight increase in its wage bill due to changes to the national living wage.

In its written evidence, the Royal College of General Practitioners said GPs worked across 516 practices in Wales in 2002 but only 374 remain today.

Angharad Fletcher, a GP in Flintshire, warned health board-managed practices are much more expensive to run compared with GMS surgeries yet deliver a “vastly inferior service”.

“GMS is underfunded,” she wrote. “Costs have risen significantly over the past five years and income has not matched that which means in some cases surgeries are having to cut staff when the demand is greater than ever.”

Dr Fletcher added: “There is no longer a workforce crisis. There are many qualified GPs looking for work. Practices cannot afford to employ them.”

One GP, who wished to be anonymous, expressed grave concerns, warning: “We are struggling to provide an acceptable service to our patients. The funding for our practice has been eroded over the last 12 years, such that I have fears there will be harm to patients.”

Another concluded: “If politicians are to be the driver of change then we need politicians on board who have vision and energy to drive this forward.

“I have dealt with two politicians from different parties over the past nine months and each left me with the feeling that no-one really understands the issues or even cares.”

 

Health

Welsh Ambulance Service invites public to AGM and Board meeting

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Annual report, finances and patient experiences will be discussed during online meetings on July 30

THE WELSH AMBULANCE SERVICE is inviting members of the public to attend its Annual General Meeting and bi-monthly Board meeting later this month.

The AGM will be held online via Microsoft Teams on Thursday, July 30, from 9.30am until 10.45am.

Members of the Board will provide updates on the Trust’s performance and financial position, as well as discussing its annual report and accounts for 2025/26.

There will also be an opportunity for stakeholders and members of the public to submit questions.

Colin Dennis, Chair of the Welsh Ambulance Service, said: “Our AGM is an important opportunity to reflect on the achievements and progress of the past year and the impact these have had on our services.

“This includes transforming the way we deliver services to provide patients with the right advice and care, in the right place, every time.

“It also gives us the chance to look ahead, share our vision for the future and explain the actions we are taking to achieve it.”

Questions can be submitted during the AGM using the Microsoft Teams Q&A function.

Alternatively, questions can be sent in advance by emailing [email protected] before Wednesday, July 29.

The Trust’s bi-monthly Board meeting will take place immediately after the AGM, beginning at 11am.

During the meeting, Board members will hear the findings of the Good Governance Institute’s recent external review of the Trust Board’s effectiveness.

They will also hear from Lucy Burrows, whose young son lives with a range of physical and neurodiverse conditions.

Ms Burrows will speak about her family’s experience of the patient-centred care provided by an attending Emergency Medical Service crew.

An agenda for the Board meeting is expected to be published on the Welsh Ambulance Service’s website shortly.

Questions for the Board can also be submitted in advance by emailing [email protected] by Wednesday, July 29.

The Microsoft Teams links for both meetings will become active around ten minutes before each meeting begins.

 

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Health

Two new surgeons appointed as Hywel Dda admits orthopaedic waits remain too long

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Health board says it is increasing capacity after figures revealed hip replacement patients waited an average of 64 weeks

HYWEL DDA UNIVERSITY HEALTH BOARD has appointed two additional surgeons as part of efforts to reduce lengthy waits for orthopaedic treatment across west Wales.

The health board confirmed the appointments after figures revealed that patients undergoing elective hip replacement surgery waited an average of 450 days during the 2025/26 financial year.

That is equivalent to more than 64 weeks from referral to treatment.

As of May 28, 2026, a total of 1,608 patients were on Hywel Dda’s waiting list for hip replacement surgery.

Sixteen patients were also removed from the list during the financial year after deciding to undergo private treatment.

Responding to questions from The Herald, Gareth Cottrell, Deputy Chief Operating Officer at Hywel Dda University Health Board, acknowledged the effect prolonged waits were having on patients.

He said: “The current national delivery expectation for health boards in Wales is to treat orthopaedic patients within a maximum of 104 weeks from the point of referral to treatment.

“In recent years, waiting times for orthopaedic treatment in Hywel Dda have been among the lowest of any health board in Wales, but we recognise that waiting times remain too long and the impact these have on our patients while awaiting the treatment they need.”

The health board said it continued to maintain dedicated ward and theatre capacity for elective orthopaedic procedures at Prince Philip Hospital in Llanelli and Bronglais Hospital in Aberystwyth.

Day-case surgery is also being carried out at units across Hywel Dda’s hospital sites.

Mr Cottrell said: “We remain committed to improving waiting times and are working closely with our regional health board partners to maximise the treatment capacity we can offer patients across the wider South West Wales area.

“During the past year, we have appointed two additional surgeons to support our continuing efforts to reduce waiting times.”

The health board did not provide details of where the new surgeons would be based, how many additional operations they were expected to carry out or when patients would begin to see a significant reduction in waiting times.

Plans to expand orthopaedic capacity also formed part of Hywel Dda’s Clinical Services Plan consultation.

Mr Cottrell added: “Improving our orthopaedic services has also been a key part of our Clinical Services Plan that we consulted upon last year, with plans being developed to increase capacity and help more patients access the care they need.”

Hip replacements are commonly offered to patients suffering severe pain, stiffness and loss of mobility after other treatments, including physiotherapy, medication and injections, have failed to provide sufficient relief.

Lengthy waits can leave patients struggling with worsening pain, disturbed sleep and a loss of independence, while some may be forced to reduce their working hours or leave employment.

The waiting-time figures were obtained through a Freedom of Information request submitted by healthcare marketplace My Medical Gateway.

The company said the health board returned its response on June 8, 2026.

 

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Health

MSs clash over funding formula as Reform call for government to abandon plans

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SENEDD Members clashed over plans to review Wales’ funding formula, following the Welsh Government’s defeat in its pursuit of change.

Constitution minister Dafydd Trystan Davies defended the Welsh Government’s stance amid Reform calls for the plans to be abandoned.

On Tuesday July 14, Reform’s Cai Parry-Jones said Plaid Cymru had experienced a “crushing defeat” last week when they were “refused” permission from the Senedd to argue for a different funding model for Wales.

He said: “Reform, with the support of Labour and the Conservatives, potentially saved £1.5 billion annually for the Welsh Government’s budget. You’re welcome.

“Now that the Senedd has spoken, will you abandon your plans to argue for a change for the funding model for Wales?”

Responding with a simple “no”, Dr Trystan Davies said: “What has become very clear in assessing the financial situation facing Wales is that we need fair funding for Wales and funding that reflects the needs of the population. Wales has nothing to fear from a review of that kind.”

Reform’s shadow finance and government efficiency minister pointed to Plaid’s manifesto promises – much of which Mr Parry-Jones described having “hinged on an optimistic change of the funding model”.

He said: “Now that the Senedd has rejected your calls to change the funding model, what changes have you made to your programme for government?”

Reform MS Cai Parry-Jones
Reform MS Cai Parry-Jones

Dr Trystan Davies responded: “I hope that colleagues across this Senedd will work to ensure that the Welsh Government and the public sector in Wales work at their most effective and that we, over the next four years, can identify more funding that can be invested in the priorities of the people, to support childcare, to support the economy, to support the health service.”

Huw Thomas – Labour’s spokesperson for finance and democracy – questioned the minister on Plaid’s funding formula review.

The former Cardiff Council leader revealed he had received a written response from local government minister Sian Gwenllian, who said that as part of the government’s funding formula review it is “reviewing the data on primary indicators” such as “those relating to deprivation and sparsity of population”.

Labour MS Huw Thomas
Labour MS Huw Thomas

Mr Thomas said there are “huge concerns” in parts of Wales that Plaid will “copy what Rishi Sunak did in England and redistribute funding via the funding formula away from poorer urban areas towards relatively wealthier rural ones.”

The Caerdydd Penarth MS asked the minister what issues he has identified in the “underlying data and indicators” that have prompted this review.

In response, Dr Trystan Davies said: “As with all official statistics, the government keeps a close eye on the accuracy and effectiveness of that data to ensure that they are clearly and accurately reflected in the formulas.

“The spokesperson himself [Mr Thomas] comes from Aberystwyth and he knows full well that there are areas of significant poverty in rural Wales as well as industrial Wales.”

He continued: “Setting those communities against each other is a disappointing approach from the spokesperson, I would suggest.”

Mr Thomas noted in response that he “didn’t hear” the minister share “what figures had pushed [him] to hold that review.”

Calls for a Welsh Covid inquiry came from both the Reform and Conservative benches in Tuesday’s plenary.

Following his questions on Plaid Cymru’s plans to argue for a change to the funding model for Wales, Mr Parry-Jones pressed the minister to confirm what actions his government will take to bring about a Welsh Covid review.

He said: “Responding to the Covid inquiry’s fifth report today, the First Minister rather vaguely said that Plaid remains committed to reviewing the Wales Covid response.

“In March, Plaid said it would hold a short, sharp and focused review of the Welsh Government’s Covid response, a far cry from the full-fat all-Wales inquiry Plaid previously called for for years, including during your 2024 manifesto.

“Now, following that u-turn, nobody knows what your review actually is – not when it’s happening, not for how long, not even what elements of the Covid response it would focus on.

“Surely, Minister, now is the time to make it clear to bereaved families what actions exactly your government is going to take.”

Dr Trystan Davies said the government is committed to conducting a Covid review. He said: “That’s what we said in our manifesto and that’s what we intend to do.

“I’m pleased to say that I have already been in correspondence with the Covid Bereaved Families on our intentions and hope to arrange a meeting with them soon, because it’s important that the voices of those who have suffered are part of that discussion and feed in to the work of government.”

Andrew RT Davies, Welsh Conservative MS for Pen-y-Bont Bro Morgannwg, also pressed the minister on his inquiry plans.

Conservative MS Andrew RT Davies
Conservative MS Andrew RT Davies

Mr Davies said it was “vital” the government “sticks to their commitment” and “enacts a Covid inquiry – not a review”.

He called on the minister to confirm that “the government’s thinking, whatever emerges, will be set up under the Inquiries Act 2005, which would compel witnesses to come before that inquiry and give evidence”.

Dr Trystan Davies reiterated that work is “progressing” on the government’s Covid review and noted he will be “liaising closely” with the bereaved families.

The Conservative MS thanked the minister for his “warm words” but described the response as of “little substance”.

Mr Davies said: “The reality is that we found out, with the Covid committee that was set up in the previous Senedd term, that unless witnesses were compelled to give evidence, that committee was thwarted in its endeavours to get to the truth.

“Today, for example, the Covid inquiry reports that, on the FFP3 respirator masks that we were told Wales was well stocked with prior to the Covid pandemic in its emergency allocation, there wasn’t a single mask in Wales available for the health service to use.

“These are the things we need to get to the core of as to what was not provided, what was mislaid, what was deliberately not ordered to save money, and what was not acted on on the emergency planning trials that were held prior to the Covid pandemic.”

He called on the Welsh Government to “stick to your guns, stick to your morals, stick to the votes that you made prior to the Senedd election and have a full-blown inquiry that gets to the truth and, ultimately, prepares Wales for any future pandemic.”

Responding, Dr Trystan Davies said: “Reading the most recent module report on Covid brings home the sobering impact of Covid right across this country.

“Those lessons must be learnt, and the review that we are committed to undertaking must have the ability to address those precise issues that you have set out and that is what we will seek to do.”

 

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