British Medical Association warns of NHS Wales crunch years

The NHS in Wales has reached a "crunch point" and politicians after the assembly election will need to look at shifting resources from hospitals, the British Medical Association has said.

Dr Phil Banfield, chairman of the BMA Welsh council, warned against structural changes.

But he said more money needed to go into GPs and primary care.

Meanwhile a health economist called for politicians "to come out of their bunker" to discuss difficult decisions.

Dr Banfield said: "The last thing we need in Wales is wholesale restructuring for the sake of it. The current government has been trying to realign local authorities with the health boards, roughly speaking.

"It would be unhelpful spending precious resources to change the NHS wholesale.

"We'd like to see more effective use of resources - so if we're asking more GPs to take over more of the burden that we have a genuine shift of resources into primary care.

"We used to see 10% of NHS budget going into primary care five years ago, that's now gone below 8%."

He said for the last two elections there had been similar conversations that the NHS in Wales needed to change "and 10 years later we've reached a crunch point".

Dr Banfield said there had been progress - with the public being encouraged to take more responsibility for being healthier and fitter - but there needed to be rebalancing between hospital and community care.

"The next government will not be able to shy away from having to make these decisions - these next five years will be a key moment for the NHS in Wales," he said.

Prof Marcus Longley, director of the Welsh Institute of Health and Social Care, said there needed to be meaningful discussions with the public about difficult decisions as demands increased.

"The government can't avoid those decisions in the long term," he told BBC Wales.

Fellow economist Prof Ceri Phillips said: "Hospitals have to be the pinnacle of the healthcare system not the first point of entry. We've seen previous elections fought on the future hospitals. That has to go, we have to be more mature as a society to understand the complexity of the healthcare system.

"We need to invest in services which meet the need of the people and that's not always at the hospital."

Prof Phillips, of Swansea University, has co-authored an independent review into the NHS Wales workforce, which found the age profile of GPs was a "cause for concern" and primary care could be unsustainable within three years.

It found the GP shortage was a "major inhibitor" to moving care away from hospitals while the reliance on agency and locums had led to "significant levels of expenditure" - £88m - which potentially compromised quality of care and patient safety.

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