1 Introduction |
1. The border between Wales and England is approximately
170 miles long, with 50% of the population of Wales living within
25 miles of the border. As a result, cross-border movements are
a fact of life, including for healthcare. Since devolution, there
has been increasing divergence between the healthcare systems
of England and Wales. These differences in policy and administration
have implications for patients who rely on healthcare facilities
on the other side of the border from where they live.
2. In April 2013, NHS Wales and NHS England agreed
a revised Protocol for Cross-border Healthcare Services to improve
the interaction between the NHS on either side of the England-Wales
3. We chose to examine cross-border healthcare because
we had heard of significant confusion amongst patients needing
to travel across the border for treatment, for example, in knowing
what they were entitled to receive from their health service.
Our inquiry has not been concerned with the merits of the healthcare
system in Wales, which is devolved to the Welsh Government and
scrutinised by the National Assembly for Wales, or England. Given
the likelihood of further health policy divergence in the future,
we believe that it is essential for robust and detailed systems
of liaison to be in place to guarantee consistent cross-border
co-ordination in years to come.
4. We took oral evidence from patient representatives,
professional bodies in the healthcare profession, Welsh Local
Health Boards, English Clinical Commissioning Groups, along with
the Welsh and UK Governments. A full list of witnesses can be
found at the end of this Report.
5. We also took the opportunity during this inquiry
to engage with a wider section of the population. We held a web
forum to allow people to submit their personal experiences of
cross-border healthcare, from which we received 36 written submissions.
We also held public events in conjunction with Parliamentary Outreach
in Newtown and Hereford to hear from members of the public, medical
practitioners and local representatives. These were well attended
and greatly informed our inquiry. A summary of the events is attached
as an Annex. We wish to place on record our gratitude to all those
who have contributed to our inquiry, especially those who attended
the events in Newtown and Hereford.