Cross-border Health Care (England and Wales)

Debate between Bill Wiggin and Anna Soubry

Tuesday 25th June 2013 Commons Chamber

[Anna Soubry]

I am grateful for that intervention and for the wise words of the hon. Member for Strangford (Jim Shannon), who, as ever, brings a great depth of experience to these matters. Yes, we will certainly take that on board.

All this came about because of a meeting between me and my officials, the Welsh Secretary and my hon. Friend the Member for Forest of Dean (Mr Harper). As a result of that meeting, I have asked NHS England to work locally with GP practices in the border counties to review their practice boundaries with the aim of providing additional choice of GPs to those who do not currently have it. I am keen that all English patients are able to access an English GP if they wish or that they can register with a Welsh GP if that is their choice and they are aware of the impact of that decision. I have also asked NHS England to review the protocol as it currently stands.

I have asked the Welsh Government to review their policy on out-of-area treatments to consider an exception for English residents—specifically, that GPs operating from branch surgeries in England should be exempt from the requirement to seek prior approval for English resident patients to be referred to hospitals in England. These are all matters of concern not only to constituents of my hon. Friend the Member for Hereford and South Herefordshire but to others. We have heard about that from my hon. Friend the Member for City of Chester (Stephen Mosley) and my hon. Friend the Member for North Herefordshire (Bill Wiggin), and of course I know of the concerns of my hon. Friend the Member for Forest of Dean.

I am informed that since the meeting with the Welsh Secretary and my hon. Friend the Member for Forest of Dean, NHS England has had several further meetings with colleagues in the Welsh Government and local health boards based in Wales to discuss these concerns so that they can be addressed. There have been constructive discussions with Aneurin Bevan local health board, which has confirmed that it will undertake a review of the application of its policy on out-of-area treatment. I understand from NHS England that work will continue on this review over the next few months, and I will of course keep everybody fully informed and up to date on any progress.

[Bill Wiggin]

Will my hon. Friend give way?

[Anna Soubry]

Of course, but quickly.

[Bill Wiggin]

I am most grateful to my hon. Friend. I am really heartened by the positive things she has said, and I congratulate her on the work she has done. Will she also look at the impact of cross-border patient numbers on hospitals, which also badly affects us in Herefordshire?

[Anna Soubry]

Indeed. I will come to the effect on Hereford hospital, but I am more than happy to write to my hon. Friend about his specific point. The usual rules apply: if there are questions that I have not answered I will of course write to any hon. Member.

We have asked the Welsh Government to request that other local health boards along the border in Wales should similarly review the application of their own policies for out-of-area treatment affecting patients in the same circumstances. In many of those areas patient numbers are much smaller, but that does not matter; these are important issues for these individuals.

In the light of the further legal advice that NHS England is seeking, I am advised that it will review the protocol with the Welsh Government in view of my concerns and those of other hon. Members, the updated legal advice, the outcome of the local health boards’ reviews of the application of their policies on out-of-area treatment, and feedback that we have received from local NHS bodies on the operation of the protocol. The review will be undertaken in the autumn following completion of the reviews by the local health boards.

My hon. Friend the Member for Hereford and South Herefordshire is concerned that the policy of the Welsh Government that those who are registered with a Welsh GP must use Welsh NHS services will have a direct impact on the viability of Hereford hospital. I share his concern, but I understand that a number of other factors affect the viability of the hospital and the Wye Valley NHS Trust.

I was a bit concerned when I read the next part of my brief, because it has been worded in an interesting way by my very able officials. It states that those factors include

“the drop in the numbers of young people locally leading to a lack of activity in maternity services”.

I am not sure what “lack of activity” young people have been guilty of. I think that what is meant is that there are not as many young people in the area, because there is undoubtedly a higher proportion of retired elderly people in the population. It is obvious that if there are fewer young people, people are less likely to be having babies and are therefore less likely to use maternity services. I am sure that activity remains at a high level.

As my hon. Friend is aware, Wye Valley NHS Trust published a strategic outline case in March this year, setting out the options for its future form to create a clinically sustainable model for local people. I have been advised by the NHS Trust Development Authority that it has been working with the trust to develop a full business case, which it expects to receive for consideration by the end of this month. Again, I make it very clear that I am more than happy to revisit this issue with my hon. Friend and others following the outcome of that process.