Improving Health Provision in Mid Wales
Updated February 2025
Proposals to delay treatment for Powys Patients in English Hospitals
During January it was revealed that Powys Teaching Health Board were considering measures to address financial pressures. Among the proposals was a deeply concerning plan asking health providers in England to slow down the delivery of planned care treatment, including outpatient appointments and inpatient procedures for Powys patients.
I had discussions with the First Minister, Health Minister and Powys Teaching Health Board, to encourage all parties to agree a way forward that would lead to these plans not being implemented. In a meeting of the Health Board on the 29th January Board Members agreed to drop the proposals. I welcomed the Board’s decision that would otherwise have seen a delay in treatment for Powys Patients in English Hospitals.
We in Powys rely on hospitals across the border in England and this proposal risked creating an unjust disparity, where Welsh patients would wait longer than their English counterparts - even though Welsh and English patients are treated by the same healthcare professionals within the same hospital.
These measures should never have been suggested in the first place. It would be ludicrous if patients from Wales were forced to wait longer for treatment due to financial constraints, especially when there is sufficient capacity to treat those patients within NHS hospitals just over the border. Many are already enduring long waits in pain and discomfort. If the proposals had been agreed, it could have meant hospital waiting times would have been extended by up to 11 weeks or longer for Powys residents. This was unacceptable.
Health Boards across Wales are responsible for planning and delivering NHS services in their areas. The seven Health Boards in Wales receive funding from the Welsh Government and allocations are made annually. During this financial year all but one Health Board submitted deficit annual plans to the Government, reporting a total deficit of £220 million. This meant that six Health Boards reported to the Welsh Government that they were projecting to overspend. In response, the Welsh Government provided £112 million of additional funding to address inflation issues and support the Health Boards during this period of financial need. The Health Boards were expected to find the balance of savings needed. For Powys, this meant they were expected to deliver a further £9.9m in savings so that the Welsh Government’s financial targets can be achieved.
Throughout January I asked both the Health Secretary and the First Minister about Welsh Government support for Powys Teaching Health Board. When I raised the need for greater financial support with the First Minister, she informed me that it would not be acceptable for Powys patients to wait longer than English Counterparts when being treated in England. Given the First Minister’s response to me, the question she and the Health Minister now need to address is how the Government will ensure the Health Board is fully funded to a point where it is able to buy healthcare capacity in England based on English waiting times, rather than the much longer NHS waiting times here in Wales.
There are several issues the Welsh Government also needs to address in my view. When funding is provided to Health Boards, there is a greater consideration to provide funding to Health Boards that have District General Hospitals (DGH) within their boundaries. What the Welsh Government need to appreciate is that whilst Powys Teaching Health Board does not have a DGH of its own, they still must pay for treatment to other Health providers outside of Powys. The Government also needs to look at other fundamental challenges such as better supporting rural Health Boards, workforce shortages and service demand, all of which are essential for ensuring the long-term financial sustainability of the NHS in Wales.
In summary, it is positive news that the proposal was dropped, and a huge relief that (generally) Powys patients will not wait longer for treatment than English patients when being treated in English hospitals. However longer term change is needed when it comes to Welsh Government support and funding for our local Health Board, to reduce the chance of these proposals coming forward again in the future.
New Mid Wales Health Facility
After many years of campaigning, a new hospital and health facility will be built in Newtown and will work side-by-side with the current network of community hospitals in Machynlleth, Llanidloes and Welshpool, as well as district general hospitals around our borders. This will ensure that we receive the right treatment much closer to home.
It is frustrating that plans are moving forward at a slower pace than originally anticipated. I am pleased though that a bid for the first phase of the project has recently been submitted.
Powys Teaching Health Board and Powys County Council are leading the North Powys Wellbeing Programme. The Welsh Government, who have previously committed their support to the new hospital and facility, will still need to approve plans. Plans are also being developed by Powys County Council for the replacement of a new school build, Ysgol Calon y Dderwen, which is currently on the site where the new health hub in Newtown will be located.
Whilst I am pleased that all organisations have continued to commit their support to the project and the new build facility, I am disappointed with the pace of progress. The project is now planned to be delivered in several phased stages, rather than in one phase, with the new facilities and build taking longer than originally anticipated.
I don’t believe the Welsh Government, Powys County Council, or the Health Board have progressed plans as quickly as they had previously committed to. I do note however that at the end of 2024 the Health Board and Powys County Council submitted a bid for funding to the Welsh Government for Phase One of the campus development. This Phase will focus on the community and primary care aspect of the project, and on developing state of the art new facilities on the campus.
Phase One services would include:
- a women’s health hub
- services for children and young people
- mental health provision for children and adults
- clinic space for primary and community care services
- bookable spaces for a range of community led wellbeing activities
- a one-stop shop for information on healthy living
- training facilities for the future health care and social care workforce
- housing advice and support, including for those who are homeless.
It is expected that the outcome of the Phase One bid will be known this Spring (2025). Funding bids for the next phases are now being worked on. Phase Two would develop replacement facilities for the services currently provided at Montgomeryshire County Infirmary in Newtown, while Phase Three would expand the range of diagnostic and treatment services available in North Powys, plus reduce the need to travel to acute hospitals outside the county for some treatments. I, along with the Health Board and the Council remain firmly focused on securing commitment from the Welsh Government for all three phases.
You can find out more and sign up to receive further updates at www.powyswellbeing.wales
I continue to support the project and am keen that the new facility will lead to much needed and improved health and wellbeing services in our area; with enhanced health checks and appointments being offered locally, and more minor operations being able to be delivered in Powys rather than having to travel out of county.
Action to Safeguard Acute Stroke Services at Bronglais Hospital
There are concerns over the future of acute stroke services at Bronglais Hospital Aberystwyth, and I raised these issues with the Welsh Government’s Health Secretary in January (2025).
Proposals being considered by Hywel Dda University Health Board include the potential downgrading of stroke services in Bronglais, a move that could have devastating implications for patients in Mid Wales.
The stakes are far too high to get this wrong. I have urged the Welsh Government and the Health Boards involved to ensure that patients in Powys are not overlooked and that their access to essential, time-critical stroke services is guaranteed.
I have asked the Cabinet Secretary for Health how he is supporting Powys patients and Powys Teaching Health Board to ensure that there are sufficient and timely acute stroke services available. It is completely unreasonable to expect patients in Powys who have suffered from stroke, to be transferred to Withybush Hospital or Llanelli.
Every hour is critical following a stroke, and all options currently proposed would mean residents would not have access to time-critical stroke care. This would again mean that Powys patients suffer.
The Cabinet Secretary for Health, Jeremy Miles, has told me that no decisions have yet been made, with a formal consultation expected in May. He assured me that an appraisal of options would be undertaken and emphasised the importance of collaborative approaches between Health Boards and delivery partners. I have also had several meetings with the Stroke Association regarding these proposals.
Changes to Llanidloes Hospital and other Cottage Hospitals
Last year, Powys Teaching Health Board announced proposed temporary changes to the provision of services at local cottage hospitals. There was particular concern with a downgrading of services at Llanidloes War Memorial Hospital. I was at a very well attended public meeting in Llanidloes last Summer, in which residents from Llanidloes and the surrounding area were present.
Not only did the hundreds of members of the public outline their concerns about the Health Board’s plans to make changes to the provision of services at Llanidloes Hospital, but it was also clear from the meeting that current and former GPs, and other local health professionals oppose the Health Board’s plans. I have a concern that what the Health Board refer to as a temporary change to the provision, will become a permanent change. I was further concerned that a downgrading of services will make it more difficult to retain and recruit staff.
In a meeting held in October (2024), the Health Board approved proposals that will change the model of inpatient care in Llanidloes for a six-month period from December 2024.
I have raised our concerns directly in the Senedd and with Ministers several times, recently asking the First Minister to consider the true adequacy of this consultation process and to clarify if the proposed changes really are temporary. The fact that these downgrades are driven by financial constraints does not instil confidence.
When I pressed the First Minister on this issue, she suggested that service changes fall solely under the remit of local health boards, distancing the Welsh Government from the realities facing our hospitals. Yet I believe the Welsh Government has a responsibility to adequately fund Powys Teaching Health Board. During December (2024) I pressed the Welsh Government on how much additional funding Powys would receive of the new funding announced. Disappointingly, Powys seemed to have very little compared to the other 6 health boards across Wales.
I will continue to raise our concerns in the Senedd and with the Health Board.
New Emergency Service Provision in Shrewsbury
Last Autumn I visited the Royal Shrewsbury Hospital. Construction has been progressing for several months as part of a plan to establish it as the main emergency hospital for north Powys, Shropshire, and Telford & Wrekin. This is an exciting development for us in Mid Wales, as it will mean access to enhanced life-saving emergency care in Shrewsbury.
The services planned are more significant than a standard A&E department. It also means the return of the women and children’s consultant-led inpatient service, head and neck department, critical care and the stroke unit being brought back to Shrewsbury.
The Royal Shrewsbury Hospital will specialise in Emergency Care, while the Princess Royal Hospital in Telford will become a Planned Care Centre, with both hospitals maintaining 24-hour Urgent Care Centres.
During my visit last year, I was able to view the work that has begun on the new four-story expansion to support these services. Visitors to the hospital this year may have noticed some disruption, as construction ramps up to bring these vital improvements to life.
Shrewsbury Hospital are also organising a drop in event at Welshpool Livestock Market on Monday 16 June 2025, between 10am-2pm, Clinicians and the programme team will be present at the event to answer questions about what the programme will mean and how it will improve patient care for our Montgomeryshire community. I attended a similar last year myself at the Livestock Market, and I encourage people to attend if they want to be updated on the works.
I believe the plans will vastly reduce current A&E waiting times at both hospitals, as well as ambulance turnaround periods. The changes and investment will help the Trust to continue confronting its wider challenges and make the necessary reforms to attract top class consultants and clinicians.
GP and Dentist Recruitment
Along with the British Medical Association Cymru Wales (BMA) I held an event in the Senedd last year in support of their campaign ‘Save our Surgeries’.
BMA Cymru launched their ‘Save our Surgeries’ campaign in 2023. They asked Welsh Government to commit to a rescue package for General Practice and to provide GPs and their patients with the support they need. Survey data, which was shared with members of the Senedd at the ‘Save Our Surgeries’ event, exposed an alarming 87% of GPs feared their rising workloads were impacting patient safety as Wales saw its 100th GP surgery close.
The continued unsustainable workload for GPs hasn’t improved and pressures are usually greater in the winter months.
There is a critical need for investment in our healthcare infrastructure and it is of vital importance that we ensure our surgeries have the resources they need to serve communities across Montgomeryshire effectively. Over recent years I have spoken to GPs locally who have outlined to me the pressures they are under, and I am fully aware that many practices do not have the full complement of doctors are needed to serve the population.
The recruitment of dentists in Montgomeryshire also continues to be difficult. I repeatedly call on the Welsh Government to work with the British Dental Association to allow dental practices to increase their number of Welsh NHS patients. I have also called for the Welsh Government to boost the number of dentists by refunding tuition fees for dentists that work in Wales for five years after their studies.
There are many residents who are unable to get an appointment to see an NHS dentist, and recently the last full-time NHS dentist in Newtown moved out of the area to work in England. I have regularly said to the previous Health Minister, and now the First Minister, that the current NHS dentistry contract is not working for dentists. A new contact must be agreed, and the Welsh Government need to make financial packages available to attract experienced dentists to come and work in rural Wales.
I will continue to raise my concerns regarding both GP and Dentist recruitment with the Welsh Government.