If he hadn’t been cremated, my late best friend would be turning in his grave. Born and bred on a small dairy farm near Carmarthen, he had benefitted from the world class education that Wales used to offer our young people, regardless of their socio-economic background.

It was taken for granted that a school like the Queen Elizabeth Grammar School in Carmarthen (founded in 1576) would send students to Oxford and Cambridge, or to study medicine or to exploit their talents wherever. Like many young Welsh medics, my friend followed the well-worn route to London for his medical training.

I think he was always destined to return home, to be a GP in his own community. With an almost innate knowledge of the people he served, came the skill that doctors admire more than anything else; clinical acumen. When a competent parent sounds worried at 2 am, you dress quickly, drive fast and call an ambulance so the meningitis can be treated. Or when the 60-year old farmer who last saw a doctor at their birth, presents with vague symptoms, something tells you to take it seriously; that way the cancer is detected early and hopefully cured.

So, he would be in despair at the latest PISA scores. The OECD run Programme for International Student Assessment published its 2025 results last week. Assessing 760,000 students (Year 11) across 91 countries, PISA may not be perfect, but it can’t be ignored either. It judges attainment level in Reading, Maths and Sciences and gives a points score. The results and a very good analysis are easy to find on the BBC News website.

Patrick Loxdale (Patrick Loxdale)

Now it is true that the OECD averages are declining right across the world. The Covid disruption may be at least in part responsible. Overall the UK scores above average. But this is dragged up by good English results, and sadly Wales appears to be well behind, declining and scoring lower than the international average. We perform worst across the four UK nations and are about 40 points behind England; experts suggest that 20 points is equivalent to a year’s academic attainment.

Put bluntly, we are two years behind England, and that can’t be explained away by difference in resources and all the other usual excuses. Inevitably there will now be an argument as to whether the English “Knowledge Based” system is better than the Welsh “Skills Based”. But wouldn’t it be great if Wales could rise above the petty squabbling and blame games, and actually focus on giving all our young people the opportunity they deserve?

Let’s consider the prize. In 20 years’ time some of the 15-year olds taking the PISA tests should be applying for NHS Consultant jobs, or establishing themselves in General Practice. Right now we aren’t giving enough of them that chance. As a result we seek to import many of our NHS medical and nursing staff. Those staff from around the world will be highly ambitious. They will want a great education for their children, and Wales may not be offering that.

So if we aren’t producing our own doctors and nurses, and we can’t attract from outside we have “fragile services”. It’s one of a number of reasons why the Bronglais Stroke Unit is likely to close.

Fifty years ago, Wales exported medical talent. Now we can’t even provide for ourselves. If we really want to put that right, it starts with our children’s education. Exclude the self-interested bickering; include real ambition, celebration of achievement and selfless leadership.

My friend was an incredibly proud Welshman. He would be weeping tears of frustration knowing that the opportunity he enjoyed is being denied to our youngsters, and that the rural healthcare he was so passionate about is in danger of wasting away.