Specialist care
16. Cross-border flows of patients for specialist
care take place more from Wales into England than vice versa.
Again, such flows are more prevalent in North and Mid Wales than
in the more urban and densely populated South. Welsh patients
receiving specialist treatment in England come from all corners
of Wales. Services are accessed in England due to:
- The non-availability of certain
highly specialised services within Wales, especially in relation
to cancer, organ transplantation, and high-security mental health
services. Evidence has also revealed weakness in specialist physiotherapy
services in Wales. Powys's dependence on England for obstetric
care has also been highlighted.
- The geographic proximity of
certain specialist centres, particularly in North Wales. Such
centres include Alder Hey Children's Hospital for specialist children's
services, the Walton Centre for neurology and neurosurgery and
the Cardiothoracic Centre for cardiac services, all of which are
located in Liverpool. We agree with the First Minister, who told
us that:
The population of North Wales is one thirteenth of
the population of the North-West of England, therefore the relationship
with even the small/medium centres, like Chester, but certainly
with Merseyside and Greater Manchester in the provision of health
services is totally different from the relationship between South
Wales, which has two million people, and the greater Bristol areas,
which would also have about two million people.[6]
17. Over recent years Wales has developed some
services that traditionally were England-based: services in the
Children's Hospital in Cardiff are perhaps the most high-profile
examples. It should be noted however that evidence suggests North
Wales citizens continue to view Alder Hey Children's Hospital
in Liverpool as the children's hospital for North Wales. Certain
specialist services have become sufficiently mainstream for provision
to be located in Wales, closer to people's homes than previously.
Where clinically safe and geographically convenient for patients,
the development of such services in Wales is to be welcomed.
18. Given the geography of Wales and the need
for a critical mass of patients to make specialist health provision
viable and effective, cross-border movement is inevitable and
natural. A key criterion for the success of health policy developed
by the Department of Health and the Welsh Assembly Government
is that it should not inhibit these flows or restrict access to
effective specialist care.
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