Cross-border Health Care (England and Wales)

Stephen Mosley Excerpts

Tuesday 25th June 2013 Commons Chamber

[Jesse Norman (Hereford and South Herefordshire) (Con)]

I start by thanking Mr Speaker for kindly granting this debate on a topic of great importance to many of my constituents and to many others living in English counties on the border with Wales.

I am grateful to two of my colleagues, my hon. Friend the Member for Monmouth (David T. C. Davies) and the Minister for Immigration, my hon. Friend the Member for Forest of Dean (Mr Harper), who have both worked with enormous diligence on behalf of constituents of theirs who have been similarly affected. I pay tribute to my constituent the indefatigable Patti Fender for bringing this issue to my attention, and to Action4Our Care, the action group which has pressed the matter so hard in Gloucestershire.

The basic problem can be simply stated. There are more than 20,000 NHS patients who are resident in England, yet registered with a Welsh general practitioner. Of these, some 3,500 are resident in my county of Herefordshire. Many of these people, like my constituents in the village of Welsh Newton—a Welsh name, but an English village—have no choice but to register with a Welsh GP because no English practice covers their location.

These people live in England, but they are being denied access to hospital services in England. That is grossly unfair, especially as for many, if not all, of them Hereford hospital is the closest and the best place to be treated. The situation also has the damaging knock-on effect of depriving Hereford hospital of revenue from patients who are being treated in Wales. The result is a double whammy: the patients cannot receive the health care that they want and need, and Hereford hospital, already undermined by the deeply iniquitous NHS funding formula, must suffer an unexpected additional financial burden. This burden is already becoming evident. Outpatient treatments for patients living in England but registered with a Welsh GP fell by 10% to 11% in March, April and May this year compared with the same period in 2012, and the hospital expects them to fall further in the months to come.

[Stephen Mosley (City of Chester) (Con)]

Is my hon. Friend aware of the situation in Chester, where the Countess of Chester hospital serves large numbers of people who live in north Wales? One third of the people presenting at accident and emergency at the Countess of Chester live in north Wales. There is no funding available for them so people in Cheshire are losing out. Does my hon. Friend think that is fair?

[Jesse Norman]

It is interesting to have the parallel case, and I thank my hon. Friend for bringing it to the attention of the House.

Let us look at the issues in more detail. The relevant NHS regulations state that legal responsibility for these patients remains with the relevant clinical commissioning groups in England, but that local health boards in Wales take day-to-day responsibility for their care. The English and Welsh NHS take their guidance from the protocol for cross-border health care services, the latest version of which was agreed by Welsh and English Ministers in April this year. However, it appears that the protocol does not give full effect to the law. Specifically, point 14 of the current protocol implies that patients from England who are treated in Wales are to be seen and treated within the maximum waiting time targets of the NHS in Wales, which are of course rather different from those of the NHS in England. Why does this matter? It matters for three particular reasons.

First, as we have seen, these South Herefordshire patients struggle to get referred to the hospital of their choice. The Welsh Assembly Government Minister for Health and Social Services has openly stated that choice is not the basis of the health system in Wales.