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Senedd Members quizzed Wales’ health secretary after a damning report revealed “alarming” shortcomings in cancer services, including a lack of leadership.

James Evans, the Conservatives’ shadow health secretary, said this week’s Audit Wales report laid bare chronic mismanagement of cancer services.

Questioning his opposite number Jeremy Miles, Mr Evans told the Senedd: “This failure has caused widespread confusion and inefficiencies in patient care.

“Despite a staggering 54% real-terms increase in spending on cancer services over the past 13 years, the NHS in Wales continues to miss the target for starting cancer treatment.

“Leadership failures have resulted in shocking delays for patients, with some waiting over 100 days to begin treatment. These delays exacerbate anxiety and lead to poorer survival rates, which are already worse in Wales than any other nation across the UK.”

‘Bureaucratic silos’

He urged the Welsh Government to fix a leadership vacuum, dismantle bureaucratic silos and ensure patients no longer face appalling delays that cost lives.

Mr Miles welcomed the report, recognising the picture painted by the auditor general that too many people are waiting too long for treatments they should be getting faster.

The health secretary said: “It is true to say for a number of cancers in a number of parts of Wales those targets are being met and sometimes being exceeded quite significantly.

“But the overall picture, I accept, is that targets are not being met.”

Mr Evans, who represents Brecon and Radnorshire, warned of workforce planning failures, severe staff shortages, over-reliance on agencies, and recruitment and retention problems.

‘Unsustainable’

He said: “These staff shortages are directly delaying cancer diagnosis and treatment, worsening outcomes for patients.

“Despite repeated warnings from organisations like the Wales Cancer Alliance, the Welsh Government has failed to deliver a comprehensive workforce strategy.”

Mr Miles pointed to a 27% increase in workforce numbers, adding that Wales is not the only country to have difficulty recruiting to certain disciplines such as radiology.

The health secretary agreed about the “unsustainable” reliance on agency staff.

Mr Evans added: “There is becoming an outrage in the public about the ballooning number of managers across the NHS compared to frontline health care providers.”

He suggested overall increases in the workforce – from 72,000 to 91,000 between 2014 and 2023 – have not addressed frontline clinical shortages.

‘Naive’

“Shockingly, administrative and estate staff have increased by 51% in that time,” he said.

Mr Evans asked: “After 26 years, how can the Labour Welsh Government justify the bloated expansion of administrative roles while patients face unacceptable delays for treatment due to a lack of frontline staff?”

Mr Miles replied: “The member makes an easy point, and a populist point, but the truth is a complex healthcare system requires people who are competent….

“There has been an increase in recruitment to the NHS across all disciplines and all important roles which enable the NHS to be effectively run.”

He added: “A world view which suggests that managers and those running the NHS simply should be taken out of the system, I think, is a very naive perspective.”

‘Fresh thinking’

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, also led on the scathing Audit Wales report during health questions on January 15.

He urged the minister to back his party’s proposed reforms of NHS governance.

Mr Miles said November’s report “echoed” a statement he gave in the Senedd and a speech he made two weeks earlier.

He told the chamber: “I was very pleased to see the kind of fresh thinking I was seeking to bring to the challenges which we face was agreed to by Plaid Cymru.

“And I see the same thing in the plan that was published … yesterday in relation to tackling waiting lists.”

‘Not up to scratch’

Mr ap Gwynfor hit back: “That’s a disappointing response because you seem to be in complete denial about the problems in the health service.”

The Dwyfor Meirionnydd Senedd Member called for a guarantee that a target for 80% of all cancer patients to receive treatment within 62 days by March 2026 will be met.

He warned that the quality and accessibility of health data is “not up to scratch”, with Public Health Wales “fundamentally hamstrung” in its ability to project future demand for services.

He said: “The Wales cancer registry is meant to provide timely data on cancer incidence … but it hasn’t published validated cancer data since 2021, shamefully this means Wales can’t fully take part in essential national cancer audits … nor global studies.”

Mr Miles replied: “We have actually improved the publicly available data and we publish on a monthly basis about 18 pages of cancer treatment statistics, so that they can be scrutinised.

“We do want to improve transparency further.”