Updated November 2025
Proposals to delay treatment for Powys Patients in English Hospitals
From July 1st, some Powys patients will wait longer than English patients, when being treated in hospitals in England. The plans proposed by Powys Teaching Health Board were agreed back in March. This will lead to Powys patients facing slower access to treatment in English hospitals despite available capacity.
The Board said it needed to consider additional action to live within-their-means and to respond to the financial expectations set out by Welsh Government. It now means hospitals in Hereford, Shrewsbury, Telford and Oswestry will operate on NHS Wales performance targets, slowing down treatment for Powys patients.
Asking health providers in England to slow down the delivery of care for Powys patients, despite there being sufficient capacity, is indefensible. It is not acceptable for Powys patients to be treated as second-class citizens.
I have raised this issue frequently in the Senedd. I asked the Government to ensure Powys Teaching Health Board is funded adequately to meet English waiting time targets for Powys residents referred across the border.
When I raised this with the First Minister, I was pleased she agreed that the situation was unacceptable. I followed up the matter in a formal letter. Sadly, the Welsh Government’s response to me was disingenuous. Given the First Minister’s repeated responses to me that the situation was unacceptable, the question I put to her and the Health Minister asked if the Government would ensure Powys Teaching Health Board is funded to a point where it is able to buy healthcare capacity in England based on English waiting times.
In the Government’s response they did not answer this question and, instead, simply confirmed that money was provided to meet the much slower Welsh waiting time targets. This means that the Welsh Government, while saying the situation is not acceptable, are indeed now accepting that Powys patients will wait longer than English patients even when being treated in the same hospital and being seen by the same health professionals, simply because they live in Powys.
I continue to scrutinise the Welsh Government position; they can’t have it both ways, stating the position is not acceptable, when they are ultimately responsible for the Welsh NHS and Powys patients.
More information is available from the Powys Teaching Health Board website
pthb.nhs.wales/powys-elective
Action to Safeguard Acute Stroke Services at Bronglais Hospital, Aberystwyth
Proposals being considered by Hywel Dda University Health Board include the potential downgrading of stroke services in Bronglais, a move that would have devastating implications for patients in Mid Wales.
In options that have been presented by the health board, Bronglais Hospital would become a ‘Treat and Transfer’ hospital for stroke patients. This would mean that following initial care, patients would then be transferred to another hospital within the Hywel Dda health board area.
At a public meeting held in June (2025) at the Great Hall, Aberystwyth Arts Centre, approximately 400 people came together from across the region to voice their concerns. There was a strong consensus at the meeting that the proposed removal of the Stroke Unit at Bronglais and the shift to a ‘Treat and Transfer’ model, transporting patients to Llanelli or Withybush hospitals will compromise patient safety and well-being. The audience, which included former clinicians expressed deep concern that these plans are both unworkable and dangerous.
I also met members of the Save Bronglais Hospital campaign group outside the Senedd in October (2025) ahead of a debate that was being held on the same day . It was a pleasure to address them and to ensure their voices were heard in the Senedd debate.
I have been pleased to address these meeting alongside other politicians; highlighted that the Bronglais Stroke Unit is a lifesaving for the people of mid Wales and he also paid tribute to the ‘Protect Bronglais Services’ campaign group. In my comments to the public meetings and in the Senedd , I pointed out the importance of family members being able to visit loved ones whilst in recovery following a stroke and sited that under the proposals, families from areas like Llanidloes or Machynlleth would face a four-hour round trip to support loved ones during their critical period of rehabilitation.
It is completely unreasonable to expect patients in Powys who have suffered from a 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.
I will continue to raise this issue with the Cabinet Secretary for Health, Jeremy Miles MS, and, as I pointed out to him in the Senedd October debate, The Stroke Association has urged a rethink of these proposals. The stakes are far too high to get this wrong. I urge 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.
Changes to Llanidloes Hospital and other Cottage Hospitals
Powys Teaching Health Board met at the end of July (2025) and confirmed the continuation of temporary service changes introduced in December 2024.
The Board agreed to maintain the current model on a further temporary basis. This included Inpatient units in Llanidloes and Bronllys continuing to focus on patients assessed as Ready To Go Home, with inpatient units in Newtown and Brecon continuing to focus on patients requiring more specialised rehabilitation.
This will mean a downgrading of services at Llanidloes War Memorial Hospital
The health board said that the temporary changes were introduced to address significant challenges in the sustainability of local NHS services.
The temporary changes will remain in place over the coming months whilst another programme looking at the future of services continues. We are told there will be a series of community engagement events expected across Powys in the autumn (2025)
It was last year when Powys Teaching Health Board first announced proposed temporary changes to the provision of services at local cottage hospitals. There was particular concern with a downgrading of services at Llanidloes Hospital. I attended a public meeting in Llanidloes last Summer, in which residents from Llanidloes and the surrounding area were present.
Not only did 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 opposed the Health Board’s plans. I have a concern that what the Health Board continue to 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.
I have raised our concerns directly in the Senedd and with Ministers several times. 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.
I will continue to raise our concerns in the Senedd and with the Health Board.
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.
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. The first phase could be open by 2028.
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.
I am pleased that phase one is now moving forward. Proposals for this phase of the new health and wellbeing hub in the centre of Newtown were made available in October (2025) at www.powyswellbeing.wales. This is the first phase of the multi-phase project to improve health and wellbeing services across North Powys.
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.
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.
New Emergency Service Provision in Shrewsbury
Construction has been progressing for since last year, 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.
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.
Ensuring Fair Access to NHS Dentistry
Like many across our community, I remain profoundly concerned about the ongoing challenges facing NHS dentistry in Montgomeryshire. In recent years, we have witnessed the loss of NHS dental contracts in both Newtown and Welshpool, resulting in periods where neither town has had a full-time NHS dentist. This has forced residents to travel unreasonable distances—sometimes up to two and a half hours round-trip—for even the most basic dental care. Such circumstances are simply unacceptable in the twenty-first century.
The Welsh Government has announced the introduction of a new dental contract, set to take effect in April 2026. This is the first significant overhaul of the system in two decades. The existing model requires dentists to recall all patients every six months, regardless of clinical need.
Under the new contract, appointments will be based on individual oral health requirements. Patients in need of active treatment or support to maintain good oral health will be offered more frequent appointments, while those with healthy mouths will see their recall intervals extended in line with clinical guidance and risk assessment. Additionally, the reforms aim to prioritise prevention, establish greater fairness in payments, and simplify contract terms and patient charges.
While these changes are promising in principle, experience tells us that the reality in rural Montgomeryshire often falls short of government ambition. Press releases and consultation documents rarely capture the complexities of delivering care across sparsely populated and geographically isolated communities. There remains a real risk that these reforms could inadvertently widen inequalities, leaving rural areas behind.
Serious questions persist about how the reforms will address the practical challenges unique to rural Wales: increased travel times, low population density, infrastructure constraints, and the high operational costs of running clinics far from urban centres. Many dentists have expressed concerns that the new performance targets are untested and may expose practices to financial risk. The British Dental Association has warned that some practices are already contemplating reducing their NHS commitment or withdrawing altogether, as they cannot afford to meet targets in areas where patients require more time and resources.
Rural communities like Montgomeryshire need more than well-intentioned policy statements. We need a transparent, time-bound plan from the Welsh Government. When will every resident in Montgomeryshire be able to access an NHS dentist in their own town or nearby locality, without facing long travel times and unnecessary expense? When will the days of being told there is no service, or only extremely limited provision, finally come to an end?
It is not enough to simply adjust contract terms or patient charges. The government must ensure these reforms include bespoke solutions for rural communities. Practical measures could include deploying mobile dental clinics, providing targeted incentives for dentists who serve remote areas, or introducing subsidies to offset the additional costs of running services far from larger population centres. Crucially, the new contract must be flexible enough to prevent rural clinics from being overwhelmed by unrealistic targets.
Ultimately, what matters to people is not the content of consultation documents, but the ability to access dental care close to home—without the burden of lengthy journeys or prohibitive costs. If this contract is to succeed in rural Wales, the government must turn rhetoric into meaningful action. Only then will rural communities feel genuinely included in the future of NHS dentistry, rather than left behind once again.