Cross-Border Health

Written by Kirsty Williams AM and published in B & R Express on Thursday 14th Feb 2008 on Thu 14th Feb 2008

This week I will be making a trip abroad. I am heading across the border to England and meeting Hereford hospital's Chief Executive to discuss the ever present 'cross border' difficulties, that judging by my mail bag and surgeries, a great many of you are all too familiar with. To those living in Cardiff this may sound like a strange and foreign concept; indeed to a Powys patient trying to get treatment it can often seem that we are caught up in the complicated world of international negotiation. But can it really be that difficult to have continuity of service across what is undoubtedly an historic and important divide, but an arbitrary line nonetheless? Living in the marches we are all familiar with the fluidity of transport and business links between England and Wales and we do of course speak the same language which can so often be an obstacle to international dealings. In Brecon and Radnorshire we know that the border is not an impenetrable barrier to our day to day activities; but it seems that to the Cardiff bubble of decision makers it is held as an impassable edge for all that is Welsh.

In the last year or so I have been contacted more and more by individuals who are being refused funding for health treatment in England. These are mostly constituents who have been receiving specialised and essential treatment in centres of excellence in England for a long period of time -months or years even. Some of these patients are receiving treatment for cancer, others for rare and life-threatening conditions. In all these cases the funding for the treatment has come up for reassessment by Health Commission Wales (HCW). HCW is an Assembly Government agency which takes care of the commissioning of specialist and Tertiary Care which is provided through specialist hospitals, treating particular types of illness, and which cannot be commissioned through the Local Health Board. HCW is refusing these constituents continued treatment in England in preference for treatment within Wales. For my constituents this has shown a lack of regard for vital continuity of care and the patient-consultant relationship; along with a disregard for expert knowledge for these individual's specific conditions. Yes we have good doctors, nurses and consultants in Wales, I am not saying otherwise, and there are many cases where they can provide a better service and treatment for Welsh patients. However there are occasions when we must admit that individual cases will be better served over the border in England. These are occasions when the patient's needs and quality of life should come before issues of insular nationalistic policy and inadequate funding; these are times when cross-border services should flow to Welsh patients' benefits.

On a number of occasions we have had had success in getting HCW to listen to patients and experts and to reconsider their decision to terminate funding of treatment in England. But there still cases where we continue the fight and I remain concerned by sounds coming from the Plaid-Labour Government which continue to question the desirability of this flow, and of Welsh residents continuing to receive services in the way that they have done previously. It has been said that in bringing these services within Wales we are doing so out of a desire for Nation-building, but I do not believe that you build a nation by forcing people to receive services in a certain place which may be less suitable. . I do not believe this is a sign of a strong and confident nation I am afraid that it is rather a sign of a weak Government ill serving its nation. Instead we should embrace and recognise the benefits of cross-border service links and use them to strengthen rather than fragment our Welsh identity and I will continue to call upon the government to do just this.