Border Issues – When we will need border controls? Bevan’s “frontier” issues..

Cross-Border Health Care (England and Wales) from Theyworkforyou – Keeping tabs on UK Parliaments and Assemblies and Hansard 25th June 2013

“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.” Jesse Norman (Hereford and South Herefordshire, Conservative)

Follow the replies from Hansard using the Link…

This problem goes back to the start of the WG – see this from 2008.ien wee choi

Wales now has more NHS patients than people as English flock over the border for free prescriptions By LUKE SALKELD 16 April 2008

And from the Daily mail in 2008:

“…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.”

Jesse Norman (Hereford and South Herefordshire, Conservative)

These two entries show that the public “swings both ways” to take advantage of whatever benefits are better in one region or another. Free prescriptions in Wales, lower waiting lists and choice in England (and probably better morbidity and mortality but are denied proper comparisons).

Can Welsh stronghold ensure continuance of free health care?

Julian Tudor Hart asks whether we can defend the NHS in Wales from increasing commercialisation outside our borders April 26th, 2013 From Clickonwales

Monmouth AM’s fury over NHS ‘Berlin Wall’ on Wales and England border

Nick Ramsay in the South Wales Echo 2nd Jan 2013

Mr Ramsay said he is receiving an increasing number of complaints from patients who are experiencing problems with accessing health services in English hospitals.

So the different Health Regions created a bureaucracy around border issues. They had to because of the politics which Aneurin Bevan had warned about in 1948:

The following statement was issued by the Bath, Gloucestershire, Swindon and Wiltshire Area Team, NHS England: (18th June 2013)

The cross border protocol was agreed in March and implemented in April 2013. Anthony Kealy, Head of Partnerships for NHS England, met with Ministers to discuss issues raised by Mark Harper MP about the cross border protocol and specific issues in the Forest of Dean. Ministers asked us to work with Wales to address this specific issue.

There was a videoconference on 11 June 2013 between NHS England, NHS Gloucestershire Clinical Commissioning Group (CCG) and colleagues from the Welsh Government and the Aneurin Bevan Local Health Board. The meeting focussed on English residents registered with a GP whose branch surgery is situated in England but is part of a Welsh practice.

Patients in Wales face cross-border specialist ops wait

By Owain Clarke BBC Wales health correspondent

Hospitals in England providing specialist care for Welsh patients have been told to delay some operations.

BBC Wales can reveal that health managers in Wales have threatened not to pay English trusts if they treat patients too quickly.

As part of a drive to save money, hospitals have been told to delay some operations, including heart surgery, until the end of March.

Update from Healthwatch Gloucestershire on cross border patient issues for Wales and Gloucestershire

England/Wales Cross Border Frequently Asked Questions

Wherever you live in the United Kingdom, generally you can use the NHS.

(Is this true for anything other than emergencies – is there still an NHS?)

However, the NHS is organised differently in each of the four countries – Wales, England Scotland and Northern   Ireland.

To make it easier for people living near the England-Wales border to understand how they can use local services, the Governments and NHS bodies on either side of the border have made some simple agreements, including a ‘cross border protocol’. This sets out ways to allow patients to see a GP over the border. Through the GP you are able to get other services in a fair and predictable way.

NHS in Wales ‘cynically takes money from English taxpayers’ 12 Mar 2013 00:01

A senior Conservative MP in a border constituency has attacked the NHS in Wales for not allowing patients to be treated in England.

A senior Conservative MP in a border constituency has attacked the NHS in Wales for not allowing patients to be treated in England.

Forest of Dean MP Mark Harper said English patients registered with a Welsh GP now faced longer waiting times and poorer quality services if they were barred from being treated in England.

He accused the Welsh Government of a “cynical move” to take cash from “English taxpayers” to maintain “under-utilised facilities”.

Conservative health minister demands action over health provision on the Wales-England border 26 Jun 2013 14:14

Anna Soubry warned ‘injustice’ between the English and Welsh health services must be tackles, in a debate about the 20,000 people living in England who are registered with a Welsh GP

Tensions over health provision along the Wales-England border have spilled over with a UK Government minister warning “injustice” must be eradicated.

During a debate focused on the welfare of the 20,000 people who live in England but are registered with a Welsh GP, Conservative health minister Anna Soubry demanded action.

Stating that people in Wales “unfortunately do not get some of the excellent access to services that we enjoy in England,” she said the interests of border communities must be addressed.

She said: “While it might not affect a huge number of people, it is a very important issue for them and they feel that there is an injustice. It behoves all of us to ensure that we eradicate any injustice.”

Jesse Norman, the Conservative MP for Hereford and South Herefordshire, led the charge, saying: “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.”

He continued: “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.”

Attacking the quality of Welsh services, Mr Norman said: “The fact that the Welsh Assembly Government Minister for Health and Social Services does not believe that choice is the basis of the health system in Wales means that my constituents do not have the choice of health care, hospitals or consultants that is their proper legal right. Secondly, the Welsh NHS’s performance in meeting its own waiting time targets continues to deteriorate.

“In England the waiting time target is 18 weeks, but in Wales it is 26 weeks, and that is regularly missed. Some patients are not even treated within 36 weeks.

“For example, some 4% of patients are not treated within 36 weeks at Cardiff and Vale hospital, according to recent Welsh Government statistics for April this year.”

Ms Soubry said: “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.

“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.”

The Welsh Government has been invited to comment.

Cross Border Information for the NHS in Wales  24 May 2013

Direction and guidance for people in Wales looking for information on all cross border services for the NHS in Wales.

Working on the border between England and Wales

23 March 2013

The report of a second major conference looking at cross border care for people living on the border between England and Wales has just been published.

Priorities and plans for health services are devolved issues. The Department of Health is responsible in England and the Welsh Government is responsible in Wales.

And finally, the English/Welsh system of deliberate inequality may fall foul of European Law:

EU Directive on cross-border healthcare

2 thoughts on “Border Issues – When we will need border controls? Bevan’s “frontier” issues..

  1. Pingback: Why are so many charities supporting an “unrationed” Health Service? | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

  2. Pingback: Health care and the Welsh elections – comparative analysis and graphics with England | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s