Nearly two-thirds of health care services in Wales have not been inspected for five years, leading to concerns about patient safety, the Senedd has heard.

Gareth Davies led a Conservative debate on the “dismal findings” of Healthcare Inspectorate Wales’ (HIW) 2022-23 annual report.

He opposed cuts to the inspectorate in the 2024-25 draft budget, saying it is shocking that nearly 60% of Welsh health care services have not been inspected since 2018.

Mr Davies, who worked in the NHS for more than a decade, raised concerns about every Welsh health board being in some form of enhanced monitoring or special measures.

The party’s shadow social services minister said the HIW report did not find any evidence of Welsh Government initiatives making a clear and significant difference to frontline services.

He told the Senedd: “This latest report sadly shows precious little improvement, with many areas that have continued to deteriorate.

“The shocking lack of inspections of Welsh health facilities needs addressing urgently and that's why we are calling for an urgent timetable to be drawn up to ensure these facilities meet the standard expected.”

Mr Davies said one in five people in Wales is on an NHS waiting list and failures in social care are leading to bottlenecks in hospital wards.

Mabon ap Gwynfor, Plaid Cymru’s shadow health minister, described the Barnett formula as the elephant in the chamber.

He called for a fundamental reform, saying the UK Treasury funding mechanism fails to cater for societal needs and means that Wales is underfunded every year.

Mr Gwynfor told MSs: “There's a good reason why the Tories haven't been upfront about the limitations of the Barnett formula, because it would involve confronting the reality that Westminster consistently gives Wales a raw deal.”

He said neither Vaughan Gething nor Jeremy Miles, the candidates to replace Mark Drakeford as first minister, have committed to calling for a review of the funding formula.

Altaf Hussain, a former consultant orthopaedic surgeon, warned that cuts to HIW’s budget will only add to a growing deficit of inspection work.

The Conservative MS for South Wales West said: “Nearly two in three healthcare services have not been inspected in the past five years, and without such vital inspections, who knows what patient safety issues are going unaddressed?”

He said 17% of Welsh hospitals and a staggering 73% of GPs have never been inspected.

Janet Finch-Saunders told the chamber that HIW scarcely has the capacity to inspect 10% of health services annually, with only 137 onsite inspections taking place.

Her conservative colleague Peter Fox described cuts to HIW’s budget as a retrograde step and a false economy at a time when the health service is struggling.

He said: “It is clear that Labour's prioritising of the wrong things has left our health service vulnerable and lacking resilience.”

Carolyn Thomas stressed that there is a health crisis across the UK – not only in Wales.

The Labour backbencher, who represents North Wales, said evidence shows this has worsened over the past 14 years since the start of austerity.

She said Wales spends 8% more on heath and 43% more on social care than England.

She added: “I believe it will be the wrong decision, as the Conservatives are suggesting, to move funding away from the health service itself and spend it on inspectorate services.”

Eluned Morgan said it was a political decision to cut HIW’s budget to instead focus funding on frontline health services.

Wales’ health minister stressed that the inspectorate visited all health boards and trusts where inpatient care is provided.

She reiterated that the Welsh budget will be worth £1.3bn less, in real terms, than when it was set in the UK Government’s 2021 spending review.

Baroness Morgan said: “We have directed, in the Welsh Government, money from all other parts of the Government to shore up the NHS.

“All parts of the NHS across the UK are struggling financially.”

She highlighted the 111 service, which diverts 70,000 patients a month, easing the pressure on A&E, and efforts to tackle the 8am bottleneck for GP appointments.

She argued that expanding HIW’s remit to include investigating complaints would not be a good use of resources at a time of constrained budgets and capacity. The Conservative motion was voted down, with the Senedd failing to agree on amendments, after the debate on Wednesday, 17 January.