Melanie Wallace, 59, a resident of Howey near Llandrindod Wells in Powys, is facing a protracted wait of nearly two years for a routine hip replacement surgery. Despite originally being scheduled for treatment in an English hospital, Melanie was told her anticipated 12-month wait has now been extended by an additional 45 weeks—a development brought about by policy changes affecting cross-border NHS patients from Wales.
A passionate gardener and motorcycling enthusiast, Melanie suffers from worsening osteoarthritis, which has left her in unrelenting pain. Though she strives to maintain her independence and working life, she finds herself increasingly curtailed by her condition, unable to enjoy activities such as walking her dogs or tending to her garden. Speaking to reporters, Melanie described feeling forgotten in the system, noting, “It’s just a big hole and this has affected all people in Powys waiting.”
Her situation highlights the knock-on effects of stretched NHS budgets in Wales, particularly for those living near the border who rely on English hospitals for certain treatments. According to Melanie, the Powys Teaching Health Board (PTHB) informed her that the policy had been revised to ensure Welsh patients, regardless of where they receive treatment, experience similar waiting times. This approach, they say, is necessary in the face of limited funding, as PTHB cannot afford to subsidise faster treatment for patients using hospitals in places like Hereford or Oswestry—a stance taken to promote fairness but with tangible human consequences.
The backdrop to Melanie’s personal ordeal is a wider healthcare challenge facing Wales. Recent statistics indicate that long waits for NHS procedures in the country are increasing, fuelling concerns about equitable access to care. Residents of Powys face unique difficulties, as the area lacks a district general hospital; as a result, nearly 40% of the local health board’s budget is used to pay for services delivered in England. The financial strain has led to the new policy: from July 1, the Welsh average waiting times must be applied to patients attending English hospitals for planned treatments, a rule likely to be extended to outpatients in future.
Melanie, who relocated from Herefordshire to Powys two years ago in search of a rural lifestyle, admits she did not anticipate such an impact on her healthcare. “You are nothing without your health,” she says. The move, initially made for the “countryside”, has proved bittersweet, as getting out and about is now a daily struggle. Melanie’s sense of frustration is not hers alone; she has submitted a formal complaint to PTHB but claims to be waiting for a response.
Local political representatives have now taken up the issue. Welsh Liberal Democrat MP David Chadwick has called for an immediate end to the revised waiting time policy, warning that it risks compromising patient welfare and was enacted without sufficient impact assessments or modelling. “Jeremy Miles and the Welsh Government need to take responsibility and step in, not continue to bury their heads in the sand,” Mr Chadwick argued, attributing the policy’s origins to underfunding at the national level.
In response, a spokesperson for the Welsh Government reaffirmed their commitment to reducing waiting times and ensuring that every Welsh resident—Powys included—has timely access to necessary treatments. They stated that health boards must operate within available resources while providing fair services for all. The government highlighted a core allocation of £400 million to PTHB, with an additional £12.5 million provided this year to compensate for the higher costs of cross-border healthcare.
A PTHB spokesperson acknowledged the frustration and disappointment these changes have triggered among patients and their families, but stressed that the policy was adopted due to “significant financial pressures.” The board maintains that harmonising waiting times is essential for providing a consistent, sustainable service for all residents. They noted, “We cannot continue to spend money we do not have to offer faster access care to some parts of the county.”
As discussions continue regarding extending the policy to outpatient care, Melanie Wallace and many others in Powys are left grappling with uncertainty, hoping for a resolution that balances financial realities with genuine patient needs. The debate lays bare the complexities and compromises currently testing the NHS across Wales and raises fresh questions about access and equality in healthcare provision for border communities.