Cross-border Health Care (England and Wales)

Lady Hermon Excerpts

Tuesday 25th June 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I congratulate my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) on securing this debate. He has raised a number of important topics—notably, the difficulties of people resident in England who are registered with a local GP whose service is deemed to be in Wales, even though the surgery may be in England. I am fully aware of my hon. Friend’s keen interest in local health matters affecting his constituents and his tireless work to support Hereford hospital. The whole House will agree that we would all expect good quality patient care, regardless of which part of the country we live in.

As my hon. Friend knows, I am very sympathetic to the concerns he has raised about English residents who are unable to access English hospital care because they are technically registered with a Welsh GP practice—even when, as I said, for a small number of patients, that GP surgery is physically situated in England.

I am told by my officials that the NHS services that any patient can access, and their NHS rights, are determined by their GP’s country of registration. As we have heard, that is formulated through protocol between NHS England and the Welsh Assembly; it means that, legally, a person has to be registered with an English GP practice to access English NHS services.

I am very concerned that despite an English border patient’s right to register with a GP practice on either side of the border, that is not always possible in practice. I recognise that, in rural communities, patients often do not feel a choice is available, given that the most accessible practice is a Welsh one. I also recognise that many people are registered with a local GP in England but the main practice is over the border in Wales. Those people may not want to change their GP practice. Why indeed should they? We could understand why they might, because in Wales people unfortunately do not get some of the excellent access to services that we enjoy in England. I am very concerned about this. I am told by NHS England that it has asked its legal advisers to review their earlier advice on the protocol signed between it and the Welsh Government with reference to the specific concerns that Ministers—that is, me—and the Welsh Secretary have raised.

[Lady Hermon (North Down) (Ind)]

It is very kind of the Minister to take an intervention at this stage. Will she kindly confirm that when she invites her officials to look at this issue they will take up the suggestion made by the hon. Member for Strangford (Jim Shannon) and look at the valuable lessons that have been learned in Northern Ireland about the useful co-operation across a land frontier with the Republic of Ireland and a key, integral part of the United Kingdom—Northern Ireland?

[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.