“What is important is that we do not become a net exporter of medical talent” – Peter Black AM

BMA Cymru have been concerned for some time about the shortage of doctors in Wales. It is a problem that we feel can no longer be ignored. For NHS Wales to maintain a high standard of delivery, sustainable solutions for the future need to be put in place now.

I have asked four Assembly Members for their take on this important issue. Today’s entry is from Welsh Liberal Democrat spokesperson Peter Black AM.



In March, the BBC reported that Wales is currently short of around 400 hospital doctors. Given that the total number of hospital doctors in Wales is only around 5,500, this is significant.

We have a significant problem with waiting lists in Wales. The latest statistics released by the Welsh Assembly Government show that there are 6,450 people who have currently been waiting for either an inpatient or outpatient appointment for over 22 weeks. The numbers of doctors available to treat them will not be the only factor in this, but it will be a significant one.

The need for new doctors in Wales is one that is not just confined to hospitals. The number of GPs under 45 has dropped considerably in the last ten years, from 951 to 743, while the number aged over 55 has increased from 272 to 450. This means we could expect roughly a quarter of our present GPs to be retiring within the next ten years or so.

Despite this, there has been no real increase in the number of GPs at the younger age of the scale during this period.

Many of those from Wales who choose to study medicine do so outside of Wales. Young people often do not want to stay in the area they have been brought up in and use their student years to explore the world by experiencing new places and people. This is natural and leads to well rounded individuals who are needed by every workforce.

However, what is important is that we do not become a net exporter of medical talent. When someone leaves Wales to study, we need to ensure that they are encouraged to return and that those who come from England to study in Wales are encouraged to remain.

As is often the case, the Welsh Assembly Government seem to have their heads in the sand over this issue. They claim that there are few vacancies and that there are good response rates to those vacancies that do appear. Even if they are correct and that is the case at present, we still have a potential looming crisis.

In healthcare, often the solution to short term problems is recruitment from abroad. However, if we have the talent, why should we have to poach professionals from other countries who have their own healthcare requirements?

The campaign currently underway by the BMA to encourage more Welsh medical students to return to Wales is a great idea and one which I very much back. Wales is a fantastic place to both live and work and we need to highlight this to students.

But this alone will not solve the problem. The government must ensure that the health boards have the funding they need to provide adequate coverage in all parts of the health service, so that the jobs are there for students to go into.

Putting off extra recruitment for later years will only make waiting lists longer, increase present GP workloads and make the problem more difficult to solve when our current medical professionals begin to retire.

The BMA are showing leadership on this issue, and now the Government need to back this up.

The WAG could be storing up a whole heap of problems over a lack of GPs

It seems as if nothing has changed yet then in terms of the future of the GP workforce in Wales, or if it has, it’s only a change for the worse. The latest round of “Workforce Statistics for General Practitioners in Wales, 1998 – 2008” just serve to highlight how much of a ticking time bomb Wales is sitting on when it comes to having enough GPs to serve the population. Put simply, the figures show how those GPs coming up to retirement age aren’t being replaced by younger doctors. I blogged on this particular issue earlier this year and so these stats just back up everything I said then.

There are several reasons as to why Wales may soon be facing a GP shortage, a key one being demographics, with lots of older, single-handed GPs coming up to retirement age in the valleys. Also in Wales, GP incomes are lower than their counterparts in England, but with a higher workload than England. There may also be less opportunity for surgery partnerships in Wales. Then of course, there has been the trend over recent years (and rightly so) for an increased emphasis on work/life balance, making it easier for more GPs to work part-time.

And just as there is no one reason, there probably isn’t one easy solution to what could be a very serious issue in the coming years. The reorganisation of the Welsh NHS is due to really come into effect over the next few weeks, which sees a greater emphasis on the role of GPs and primary care, so it really is about time that the Government here starts taking the recruitment and planning of the Welsh GP workforce seriously. Otherwise, as the old classic song goes "There may be trouble ahead..."