The Welsh Government has acknowledged that geography heavily dictates life expectancy in modern Wales, after a Senedd debate highlighted that a quarter of the population—around 750,000 people—remains trapped in an “unacceptable health gap” due to decades of economic stagnation and political failure.
Plaid Cymru MS Matthew Jones, representing Sir Fynwy Torfaen, said the need to tackle these inequalities was one of the “main reasons” he stood for election. Speaking of his own constituency, he said: “Pontypool… and communities across Torfaen are proud places with a strong history and identity. Post-industrial communities like these have yet to fully recover from Thatcher’s de-industrialisation. Austerity has only made this worse.”
Health Inequalities Between Neighbouring Communities
Mr Jones highlighted stark disparities between Torfaen and neighbouring Monmouthshire. He stated: “Cancer incidence in the Torfaen coalfield wards is higher than the rest of my constituency. Similarly, chronic conditions are 5% more common in the Torfaen wards. Mental health conditions are present in a third of GP cases in the Torfaen wards. Premature deaths and long-term illness are much higher in Torfaen than in Monmouthshire. So too are personal independence payment and Universal Credit claimants. This makes the residents in Torfaen much more vulnerable to UK Government benefit changes.”
He emphasised that “every statistic represents a person who may be struggling to find work, or a family who may be struggling with the health of one or more of its members, a child going to school hungry.” He clarified that his comparisons were not meant to diminish challenges in Monmouthshire but to highlight inequality felt by former coalfield communities.
Broader Determinants of Health
Mr Jones noted that “health barriers do not stop at the clinic door,” citing transport, housing, food, money, and isolation as key factors. He shared that people in Blaenavon supported by the Coalfields Regeneration Trust have spoken about the difficulty caused by a lack of community transport.
He asked the Senedd to consider someone going to Velindre Cancer Centre for treatment, which could involve travelling up to five days a week for several weeks. “If they rely on hospital transport, they can be picked up hours before their appointment and get home hours afterwards. And unless there’s an approved clinical need, they may have to make that journey without a family member or a carer with them. For someone who is already exhausted, vulnerable and immunosuppressed, that’s not a small thing. It affects their wellbeing, their quality of life, and sometimes even the choices they feel able to make about their treatment. This is what inequality looks like in practice. Where you live and what transport is available to you can shape your experience of cancer care.”
He also pointed to the role of food and money in furthering inequalities, sharing the story of an individual supported by the Coalfields Regeneration Trust who received a Macmillan grant and emergency food support when their household income fell due to a diagnosis.
Economic Disadvantages and Prevention
Mr Jones highlighted economic disadvantages facing the south Wales coalfields: “More local shops can make it easier for people to get those essentials, and cafes and pubs can all build communities. Local enterprise can play a key role in reducing inequalities.” He linked economic inactivity to poor health, stating: “Lower employment, higher levels of economic inactivity linked to long-term sickness, poorer health outcomes and deeper concentrations of deprivation are not abstract policy terms - they are the lived reality of communities like those in Torfaen and across the south Wales coalfield.”
He stressed that not every challenge is unique to coalfield communities, but “what we see in the coalfield is a significant concentration of disadvantage, shaped both by present-day deprivation and by the long shadow of industrial decline.” Focusing on prevention, he said: “If we only intervene at the point of crisis, when somebody’s already ill, already out of work, already in unsuitable housing, or already struggling to cope, then we’re not tackling inequality at its root; we’re simply managing its consequences.”
Rebuilding Community Life
Fellow Plaid Cymru MS Sera Evans, of Afan Ogwr Rhondda, echoed Mr Jones’ comments: “The insecurities of the post-mining economy in south Wales brought new health challenges, compounded by the degeneration of town centres that once fostered association and community, that once housed places that gave people connection and purpose. Communities have paid a high price as a result of their loss, reflected in rising levels of isolation and loneliness, leading, inevitably, to poorer health outcomes.”
She noted success stories, such as her home town Treorchy being recognised as the UK’s High Street of the Year in 2020. She added: “If we’re serious about tackling health inequalities in our former coalfield communities, then surely we must also be serious about rebuilding the places that bring people together and restoring that culture of communal life that orbited the old industries.”
Government Response
Deputy minister for public and preventative health, Nerys Evans, said she will “act to bridge the unacceptable health gap that exists.” She acknowledged the need to understand the specific needs of coalfield communities and called it an “uncomfortable fact” that in Wales today, “where a person is born, where they’re brought up and where they live has a deep influence on their health, on their life expectancy and how many years they can expect to live in good health.”
She said: “These communities powered the industrial revolution and fuelled the prosperity of Wales and far beyond. They produced the coal and steel that helped shape modern Britain, and they built strong traditions of solidarity, resilience and community that remain a source of pride today. But our industrial heritage has left a legacy. The health inequalities that we see today are the result of long-term social and economic change. They have been shaped by our industrial past and by the decline of the industries on which many families and communities depended.”
Ms Evans added that these inequalities are the “result of political choices” made by both Westminster and previous Welsh Governments, who “failed to give enough priority” to these communities. She said her government is “determined” to address these inequalities and “committed” to making fairness “the foundation of everything we do.” She will set out her priorities for public and preventative health next week, concluding: “The challenge before us is not simply to treat illness more effectively, it is to create the conditions across government for better health for all. Because good health should never depend on wealth. Because where someone is born should not determine how long they live. And because the gap between the healthiest and the least healthy communities in Wales is not inevitable.”
