Memorandum submitted by Mr and MRS M and J Robinson of Hay-on-Wye

(CBPS 16)

PROVISION OF CROSS-BORDER PUBLIC SERVICES FOR WALES

(HEALTH SERVICES)

1 We are Mr and Mrs M and J Robinson of Hay-on-Wye.

2 We would like to acquaint the members of the Committee with our personal views on these matters. We believe that in general the evidence which you are taking does not include that of residents in the Marches of Wales, those, in fact, who actually experience the day to day provision of such services. We further note that few members of your committee represent border constituencies and therefore may not receive much information from the public on these matters.

We cannot comment on social care but would like to submit our experience of health care as it has affected our family over past years. For sixteen years we lived two miles into England and for the past five years we have lived one mile into Wales. Our doctors' practice is, and has always been, in Hay on Wye (Wales)

During our residence in England attendance at hospitals has been:

Hereford County hospital: A&E, Eye treatment, various scans but with follow-up care of Physiotherapy at Bronllys (Wales), other scans Abergavenny(Wales)

Since living in Wales:

Hereford County Hospital A&E followed by

Physiotherapy Bronllys; convalescent care and terminal care also at Bronllys.

3 In an area of low population density we feel that cross-border services are essential. We fully appreciate that our widely dispersed and small (by city standards) hospitals need to concentrate on areas of care, especially to uphold clinical excellence.

4 Remember that Powys does not possess a major A&E dcepartment. Therefore Hereford or Shrewsbury are often the nearest A&E though possibly as much as 50 miles away. The current poor performance of the Welsh Ambulance trust can hardly be helped by emergency vehicles being off station for long periods of time.

5 Hereford Hospital depends on 30% of its patients coming from Powys. Without that input Hereford Hospital is probably not viable in the long term. Some current government thinking about the critical mass of population which should be served by a general district hospital does not seem to take such rural areas into account.

Without the convalescent beds at Bronllys and other small hospitals along the border, there would be bed-blocking in Hereford.

6 Without cross-border provision many patients and their visitors would have to travel even greater distances than those they suffer now. Economic and environmental impacts of such journeys - rarely possible by public transport - should be taken into account.

Westminster and the Welsh Assembly should be encouraging, i.e. funding, the rapid development of remote diagnostic and consultative facilities. In such ways the excellence of NHS services at many levels will be optimised and patients will, in as many instances as possible, receive treatment at points of delivery convenient to them. Whether this is at local facilities (Hay, Bronllys), district (Hereford, Abergavenny) or tertiary (Birmingham, Gloucester, Cwmbran - in the future, Cardiff) should be based on medical grounds and not on political or accounting boundaries.

7 The idea that keeping services within Wales enhances National identity falls down if people are forced to receive services at great inconvenience and risk to their health. Cross border links have enormous benefits in this rural area.

8 We cannot comment directly on:

Provisions for co-ordination

Funding arrangements

But we welcome current efforts in Powys and Herefordshire at increasing collaboration between Health and Social Services and we trust that the Welsh Affairs Committee will strongly press for the removal of administrative and budgetary constraints and obstacles to the continuing and indeed enhanced provision of Cross Border Public Services.

13 March 2008