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Cross-border Health Services

Volume 491: debated on Wednesday 29 April 2009

2. What discussions he has had with ministerial colleagues and the Welsh Assembly Government on treatment in hospitals in England of patients resident in Wales and in hospitals in Wales of patients resident in England. (270718)

4. What discussions he has had with ministerial colleagues and the Welsh Assembly Government on treatment in hospitals in England of patients resident in Wales and in hospitals in Wales of patients resident in England. (270721)

My right hon. Friend the Secretary of State and I have regular discussions with ministerial colleagues and the Welsh Assembly Government on such matters. The discussions include the new cross-border protocol for health care services of Wales, which, I am pleased to say, has been agreed between the Welsh Assembly Government and the UK Government.

I am grateful to the Minister for those comments. He will be aware of the recent Welsh Affairs Committee report on cross-border health policy, to which he referred in his preliminary comments. He will also be aware that there should be clinical excellence for all those who wish to have medical treatment, as close as possible to their homes. Does he acknowledge that that would mean Welsh patients ending up having medical treatment in English hospitals? Will he do all that he can to urge the Welsh Health Minister to abandon her so-called in-country policy, which is causing so much distress to neurosurgery patients in Wales?

The hon. Gentleman is correct in referring to the Welsh Affairs Committee interim report on the provision of cross-border health services in Wales. We have considered that important report, and the Department of Health will respond to all its points in due course. It is important to recognise, however, that devolution is about addressing particular needs. The Welsh Assembly Government have clearly defined and articulated their policy, and we are seeing consistent and radical improvements in the health care of the people of Wales. Obviously, given the unique situation with regard to the Welsh-English border, a close working relationship is needed. I am absolutely confident that the protocol that is now in place and is being implemented will ensure effective co-operation and cross-border flow to the benefit of English and Welsh patients.

The Minister has referred to the difference between health care in Wales and England. With the outbreak of swine flu, and the possibility of a pandemic, is the Minister confident that the people of Wales will get the same treatment as in England?

The hon. Gentleman raises an important question. Only yesterday, I had a telephone conversation with Edwina Hart, the Welsh Assembly Government Health Minister, and I am absolutely confident that the greatest co-operation is taking place between central Government and the Welsh Assembly Government. I am pleased that she will make a statement to the Welsh Assembly this afternoon outlining her measures in some detail. She is participating fully in Cobra in London, and I am told that £59 million has been earmarked in Wales for effective preparation and response.

I very much welcome the protocol and agreement reached between the Welsh Assembly Government and the Department of Health on such important cost and funding issues. Does my hon. Friend agree that, prompted by the Welsh Affairs Committee’s inquiry into health and cross-border issues, it is now essential to make it a principle that access by Welsh patients and my constituents to English hospitals must be on the basis of clinical need, not geography? Is it not also important that Welsh Members of Parliament have the opportunity to discuss those issues in this House? That would be under threat if the Tories’ English-only policy were to come into effect.

My hon. Friend makes important points, and I congratulate him on his excellent work to ensure an effective relationship between England and Wales on the important matter of the health service. He stresses rightly that we have a national health service in this country covering both sides of Offa’s dyke, although devolution means that there is a variation on that. The principle of clinical need is cardinal to the operation of the health service in both our countries. I also agree strongly that ongoing dialogue on cross-border health is very important. It is vital that Welsh MPs, in the number that there are, contribute effectively to that debate. We would strongly oppose any attempt, suggestion or move to reduce the number of Welsh MPs, particularly with regard to this important issue.

The Minister referred to the Select Committee report and concerns about the lack of co-ordination between the Department of Health in London and the Welsh Assembly Government, and, in particular, the strains that the previous arrangements placed on clinicians and patients. Is he satisfied that the new protocol, which amounts to an interim protocol, is robust enough and, crucially, transparent enough to assuage the concerns of many of my constituents—and doubtless his—who seek treatment in Gobowen, Frenchay, Hereford and elsewhere? A lot of early misinformation was provided about cross-border health flows.

A revised cross-border protocol for health services has been agreed with the health service in Wales and the Department of Health here in London. It has rightly taken a long time to formulate, because the issue is far from straightforward and both parties wanted to be absolutely certain they were taking the best possible approach. I believe that that is what is now contained in the cross-border protocol, which has been well received. I am confident that it will be effective for patients in Wales and England.

The Minister will be aware of the recent media attention on the concerns expressed by the Muscular Dystrophy Campaign over the lack of specialist care in Wales for people with neuromuscular conditions and their difficulty in obtaining treatment in England. The MDC has argued strongly for the establishment of a UK-wide national commissioning group for specialist diagnostic services. Is he willing to approach the Secretary of State for Health to explore the possibility of establishing such a service, which would very much benefit the people of Wales and would be very much welcomed by his colleagues in the Welsh Assembly?

The hon. Gentleman raises an important issue with regard to muscular dystrophy. By definition, the issue is a cross-border one, and I would of course be more than happy to have discussions with the Department of Health and with Edwina Hart, the Welsh Assembly Government Health Minister. One of the positive things over the past few months has been a growing partnership between health services. It is true that things can be done differently—that is what devolution is all about—but it is essential that in these post-devolution times we have a constructive dialogue at all times. I shall ensure that this issue is taken forward, as he suggested.