CMW Manifesto 2026 – more coming soon
Public Services – professional education standards
Across public services we observe falling standards required. We observe this in the Fire Service, the Courts, Probation and elsewhere. The NHS is no exception. Decision makers, including governments, believe the public will be placated by ‘access’. Problem? In the modern world of media – people are slowly getting more aware that NHS doctor substitution does not necessarily mean an improved service. What’s to be done? In Cymru we have 50/60 unemployed PAs, and unemployed doctors. Meanwhile an extra 20+ PAs are to be trained in 2025 with no prospect of employment, while officials privately review the situation. It doesn’t add up.
The NHS, Physician Assistants (PAs) and Patient Safety
Summary: We highlight the importance of patient safety; in the way future services are planned & delivered.
In response to patient concerns about NHS workforce planning, we welcome Welsh Government agreeing in principle to recent (Leng) review recommendations. Noting that “further work is required to determine how best to implement these in a way that reflects specific needs and context of health services in Wales” (CMO speak). We propose:
- Patient safety standards knows no boundary and must apply both in England and Wales.
- Individuals working outside their competence and expertise in healthcare settings compromises safety.
- Claims, such as ‘trained in the medical model’ and PAs claiming they did ‘medical school in two years’ undermines public trust.
- Medicine should not be treated as a checklist of procedures. It’s a living system of anatomy, physiology, bio-chemistry, pathology and human behaviour. Skipping the base is like flying a plane without understanding aerodynamics – catastrophic.
- There should be no room for local employers substituting doctors with a less trained and qualified workforce.
- With General Medical Councils refusal to set and enforce a UK Scope of Practice, we propose the re-allocation of funds for PA training to be used instead for training and employing doctors – they are more effective, flexible & cost less.
- Advanced Clinical Practitioners (ACPs) are necessarily any better educated or trained than PAs or any less a risk to patient safety.
- Future recommendations in implementing the ‘Leng’ review require meaningful public engagement.
Background:
Owing to patient safety concerns the English ‘Leng’ review was commissioned, and Wes Streeting has accepted all the recommendations. PAs are now assistants, not associates. It needs to be clear that patients are often unaware they have seen a PA nor understand the limitations of their role, so the patient could mistakenly think they have seen a doctor when they haven’t. Leng provides a framework for Wales to standardise the use of PAs / Anaesthetist Assistants and to ensure they work to similar scopes in line with patient safety concerns.
8 October 2025
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A Manifesto for Co-operative Education in Wales
From Birth to Business Schools: A Whole Nation Approach to Co-operation, Collaboration and Community Cohesion
Wales stands at a pivotal moment. Economic inequality, climate pressures, digital fragmentation and social division demand new ways of learning, working and living together. This manifesto proposes a national strategy to embed co-operation across the entire Welsh education system, from the earliest months of life to higher education, apprenticeships and lifelong learning, so that co-operation becomes a defining feature of Welsh society.
A Co-operative Wales is built not only through enterprises, but through people. The manifesto sets out how co-operative values, habits and competencies can be cultivated progressively through every learning phase. It argues that children first encounter co-operation through relationships, trust and belonging; that young people must learn the knowledge, skills and democratic habits needed to participate in co-operative life; and that adults benefit from structures that support community, voice, fairness and shared endeavour.
Read the full Manifesto here:-
CW 17:12:25 Coop Education manifesto
18 December 2025
