Wales launches new provisional NHS

James Downs, Mental Health Campaigner

Healthcare is devolved in Wales, and with that comes the opportunity for innovation. Seizing this chance, the Welsh Government has boldly reimagined healthcare itself by launching the world’s first “Provisional NHS”. Waiting times are now provisional, like weather forecasts and, in my experience, the bus timetables on Gower.

Why wait seven weeks for “official data” when you can enjoy a sneak peek at draft figures that make everyone look healthier, happier, and more efficiently treated than they are? Why include the suffering and pain of thousands of people in your draft when such minor details can be added later on? Why talk down our country’s most treasured organisation with the doom and gloom of reality?

Ministers insist this isn’t electioneering; it’s modernisation. Reality is, after all, a lagging indicator. What matters most to patients is the idea of what the NHS could be, rather than what it actually is.

The Provisional Patient Experience

Provisional statistics, naturally, require provisional patients. Illnesses can exist in draft form, so long as their treatment is hypothetical. Whilst patients may say that they want to feel better, what really matters is the fact that their care pathway exists, not how they are progressing along it. Experts have agreed that this “yellow brick road” approach is truly novel within medicine.

The Welsh people really ought to be grateful for such innovation! If your surgery is cancelled, you’ve provisionally survived your illness, which is an excellent clinical outcome. Cancellations are also vital to driving progress, because adverse events and critical incidents are dramatically reduced for procedures that never happened.

And of course, if you are mentally ill, your physical health needs are all provisional anyway. They are most likely to be “all in your head”. I’ve seen the benefits of this approach first-hand. I once went to A&E with chest pain and was told I was “attention-seeking” and have a disordered personality. “How wonderful to see such a surge in mental health awareness!”, I thought.

In reality, I had a pulmonary embolism. But from a statistical perspective, I was provisionally fine, because no one had written it down yet.

The Reality Behind the Draft

Of course, behind the satire lies the familiar cruelty of waiting for so many people in Wales. The first time I waited for eating disorder treatment in Cardiff, it took over 6 years to see a specialist. The second time, it only took 9 months – progress which was very reassuring when I had a severe and often life-threatening illness.

When I was finally seen, I was then told that my illness was too complex and severe to assess within an assessment session. After all, who would expect an assessment process to be able to provide an assessment? I was put back onto the waiting list for a more detailed assessment, which hugely improved my position in statistical terms.

Examples such as this are replicated thousands of times across Wales. They illustrate the real power of provisional politics to make people’s lived realities disappear into technicalities while targets are massaged for headlines. For governments, it’s just a question of data release schedules. For patients, it’s months or years of life that are lost.

Political Solutions are Pending

Opposition parties smell electioneering on behalf of Labour, who insist they are merely releasing figures earlier in the name of transparency.

Reform UK have also denounced the move as cynical, though their own position on Wales and the NHS is still in draft form.

Sometimes the Senedd should stay, and sometimes it should go. The NHS is provisionally a public service, but must be open to other models. In all cases, Reform insists that the Welsh language is the primary source of NHS waste, and that surgical outcomes are greatly improved by a backing track of “God Save the King”.

Plaid Cymru, meanwhile, were unavailable for comment, as they are provisionally considering the possibility of thinking about drafting a potential pathway to Welsh independence, pending verification.

Official Results to Follow

When voters head to the polls in 2026, Welsh Labour will be banking on them being provisionally convinced that the NHS is healthier than ever. But if the polls are to be believed, Plaid and Reform are neck and neck, while Labour trails behind. Labour will no doubt defend these opinion polls as provisional, saying what really counts is the official result in May.

But for too many patients waiting for treatment, what’s really needed is relief, not just from their pain and suffering, but from a politics where the highest ambition is provisional success. The potential of Wales cannot exist in draft form only, it must be met with the decisive action and confidence that real change demands.