GP Practices in Wales on Brink of Collapse Amid Growing Demand

General practitioner (GP) practices in some of the most deprived areas of Wales are facing imminent collapse due to being under-resourced and overwhelmed, as highlighted during a recent inquiry by the Senedd. On November 6, Adrian Edwards, a professor from Cardiff University, presented evidence indicating that these practices are struggling despite serving populations with the greatest healthcare needs.

Healthcare Disparities in Wales

Professor Edwards referred to the “inverse care law,” a term coined by GP Julian Tudor Hart in 1971, which suggests that the availability of good medical care tends to be lower in areas where it is most needed. He emphasized that Wales has the lowest number of GPs in the UK, with just 45 GPs per 100,000 population, in stark contrast to Australia’s 121, Canada’s 103, and New Zealand’s 74.

Edwards pointed out that the number of GPs in Wales has remained largely unchanged since 1947, while resources have increasingly been directed towards hospitals rather than preventive care. He noted that NHS spending on general practice in Wales has declined from 11% to 7.6% over the last two decades, further exacerbating the crisis.

During the session, Professor Edwards highlighted the growing disparity in patient load between affluent and deprived areas. He stated, “In affluent areas of Wales, the average number of patients per GP is 2,100, while in deprived areas, it rises to 2,400. Furthermore, those practices receive 7% less income to provide those services.” This means that doctors in poorer regions are not only handling more patients but also have fewer resources to deliver care.

Urgent Call for Action

The situation has reached a critical point, according to Deep End Cymru, a network of GPs focused on improving healthcare in Wales’s most disadvantaged communities. Dr. Jonny Currie, a GP partner at Ringland surgery in Newport and policy lead at Deep End Cymru, warned that for every 10% increase in patients from the poorest areas, practice income falls by an average of 1%. He stated, “We’re looking at tens of thousands less money coming into general practice, despite greater demand.”

Dr. Neil James, chair of Deep End Cymru and a GP partner in the Rhymney Valley, echoed these concerns, stating that many practices are failing and “going to the wall” due to insufficient funding and overwhelming patient loads. He described the impact of societal disintegration on health outcomes, saying, “Having lived and worked in the valleys… you’ve seen societal disintegration and the effects that has on patient health has been profound.”

Professor Edwards also brought attention to alarming statistics revealing that over the past three years, 10% of practices in the poorest areas have either closed or merged, compared to just 2.8% in more affluent regions. This trend underscores the urgent need to address healthcare inequalities across Wales.

Deep End Cymru’s evidence has highlighted the stark human cost of these disparities. Women in the most deprived communities spend an average of 16.9 more years living in poor health, while men face a gap of 13.3 years. As the crisis deepens, the call for immediate action to support GP practices in these vulnerable areas is becoming increasingly urgent.