Press release

The NHS at 75: We need a national conversation on how we meet the needs of future generations

The Welsh NHS Confederation is calling for a national conversation on how we co-produce a health and care service for the future.

4 July 2023

As we come together to celebrate 75 years of the NHS, the Welsh NHS Confederation is calling on the Welsh and UK Governments to hold a national conversation on how the health and care system can innovate and transform to meet the needs of future generations. 

Launching its report to mark NHS 75 at the Senedd on Wednesday 5 July, the Welsh NHS Confederation says we must use this opportunity to start the public debate about the health and care system of the future. 

We know the public have an enduring faith in the NHS and its founding principles of providing care to all, free at the point of need. However, it’s a widely shared view that our health and care services are not sustainable in their current form. In the last 75 years, the make-up of our population has changed dramatically. Average life expectancy of women and men in England and Wales has improved considerably - by more than 12 years since 1948 – something to celebrate as a success.  

But an ageing population with increased frailty and long-term conditions brings with it fresh challenges for health and social care. The NHS faces these challenges against a backdrop of increasing demand, with immediate pressures impacting health and care services’ ability to plan in the long term.  

We must take this opportunity to co-produce and redesign services to ensure they better meet the changing needs of the population, so that services remain sustainable in the future. This includes the NHS supporting people to make decisions about looking after themselves and staying independent, ensuring they have access to the most appropriate care to meet their particular need.    

But access to healthcare only accounts for around 10 per cent of a population’s health, with the rest shaped by socio-economic factors. For example, Wales has the highest poverty rate among the four UK nations, with over a third of children (34 per cent) classed as living in poverty.  

Wales faces a significant number of population health challenges which stall life expectancy and widen inequalities. Many of these are beyond the direct reach of the NHS. Improving population health and wellbeing requires an integrated approach across services and sectors. We need the government to redirect resources towards long-term investment in public engagement and communication as well as preventative population health measures across all sectors, including good housing, education, transport and access to the arts and leisure. All sectors have a role to play in creating a preventative model and collectively we need to create the economic, social and natural environment in Wales to support good health and wellbeing throughout the life-course. 

It is not an option to continue on the current trajectory, with change needed now. We need an open and honest conversation with the public about what the future health and care service looks like. This must be centred on an NHS that is adequately and sustainably funded, an NHS that is taking care and prevention to people and their communities, an NHS that empowers and enables, and one that benefits from improving public health. It must be based on an ambitious and honest partnership between the NHS and those it serves. 

Director of the Welsh NHS Confederation Darren Hughes said:  

“The NHS has a history of continuously adapting to respond to opportunities and challenges. Today, the NHS continues to drive innovations in patient care, none of which would be possible without the skill, dedication and compassion of NHS staff, as well as the many social care staff, volunteers, third sector, unpaid carers and communities that support the health and wellbeing of the nation.  

“But this alone is not enough to ensure the sustainability of our health and care services for future generations, meaning the need for a national conversation has never been more pressing. Despite all the operational challenges, the public’s unwavering commitment to the NHS should not be taken for granted.  

“The challenge now is to use the historic moment of the NHS turning 75 to unite behind a shared vision of the NHS’s future. It is for the population and all sectors across Wales to ask what they can do to support the health and wellbeing of people now and in the future. Change must happen, it’s simply not an option to stay as we are – we need to think about the future now.” 


  • The Welsh NHS Confederation represents the seven local health boards; three NHS trusts; Health Education and Improvement Wales; and Digital Health and Care Wales. We are part of the NHS Confederation and host NHS Wales Employers. 
  • This report will be launched at the Senedd on Wednesday 5 July to celebrate the NHS at 75, where guests will hear from the National Poet for Wales, among other speakers. 
  • Hanan Issa, National Poet of Wales, has penned ‘The Unsung’ to mark the 75th anniversary of the NHS in Wales. The poem and its Welsh translation by Grug Muse were commissioned by Literature Wales. Hanan Issa researched for the poem by seeking out the experiences of some NHS workers who are unsung heroes, including pathology lab staff, staff at a GP practice and mental health practitioners. The poem will be published on 
  • Sources of statistics can be found in our report.  
  • Follow us on Twitter: @WelshConfed 
  • All our press releases and statements are available in our media centre.  
  • For media queries, please contact or call 07483 091 525. 

About us

We are the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland. The members we represent employ 1.5 million staff, care for more than 1 million patients a day and control £150 billion of public expenditure. We promote collaboration and partnership working as the key to improving population health, delivering high-quality care and reducing health inequalities.