UNCORRECTED TRANSCRIPT OF ORAL EVIDENCE To be published as HC 26-ivHouse of COMMONSMINUTES OF EVIDENCETAKEN BEFOREWELSH AFFAIRS COMMITTEECROSS-BORDER PROVISION OF PUBLIC
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Transcribed by the Official Shorthand Writers to the Houses of Parliament: W B Gurney & Sons LLP, Hope House, Telephone Number: 020 7233 1935 |
Oral Evidence
Taken before the Welsh Affairs Committee
on
Members present
Dr Hywel Francis, in the Chair
Nia Griffith
Mr David Jones
Mr Martyn Jones
Alun Michael
Albert Owen
Hywel Williams
Mark Williams
________________
Memorandum submitted by Welsh Assembly Government
Examination of Witnesses
Witnesses:
Mr Ieuan Wyn Jones AM, Deputy
First Minister for
Q126 Chairman: Good morning. Welcome to the Welsh Affairs Committee at this inquiry into cross-border policy in relation to transport. Minister, could you introduce yourself and your colleagues, please?
Mr Wyn Jones: Good morning. I have with me today, on my immediate left, James Price, who is the Director for Transport and Regeneration, and on his left is Tim James, who is the Director for Integrated Transport, and on my far right is Martin Stevenson, who is the Head of Transport Policy, and on my immediate right is Tracey Burke, who is the Director of our Economic Renewal Programme.
Q127 Chairman: Thank you for that, Minister. Could I begin by asking a very straightforward question about relationships between yourselves in the Welsh Assembly Government and the Department for Transport. Have they improved over the last year and could you illustrate that, please?
Mr Wyn Jones: Yes, I think they have
improved in the sense that at ministerial level we have had a number of
meetings, particularly with Lord Adonis who, I think, at this time last year
was a minister in the Department, now obviously the Secretary of State. I have had a number of telephone
conversations with him. What I was
pretty anxious to do was where there was clear commonality of interest, for
example over the proposal on the electrification of the line, there should be
better working relationships, not only at ministerial level but official level
as well. I was very pleased that he
agreed that there should be a team from the Welsh Assembly Government officials
talking to his officials about the costings and the programme for
electrification. That happened and we
then had the announcement about the proposal to electrify to
Q128 Alun Michael: You have answered part of my question about the way that the proposal on electrification was developed. How satisfied are you that those processes of communication have now been embedded? It is very easy to have communication that is good, it depends on personalities like the two ministers communicating well, but are you satisfied that the capacity for communication is embedded for the long-term now in the relationship between the Assembly and the Department?
Mr Wyn Jones: The signs are good. One cannot give absolute guarantees. Perhaps the most recent example where there have been discussions is not just at an operational level but with the LCO which we are pursuing in the Department on transport where there had to have been good discussions. We kicked that off with a discussion at ministerial level where we asked whether the Department was minded to grant those powers and then it went down to the official level. Provided there is a strong ministerial steer then those relationships will continue well.
Q129 Alun Michael: You feel that the Department "gets it" as far as devolution and joint working is concerned?
Mr Wyn Jones: There are still issues in certain areas around that but, by and large, it is an improving situation.
Q130 Albert
Owen: Good morning, Minister. Still on electrification, does the Assembly
Government have priorities other than working with the Department on the
Swansea-London link cross-border, for example, to the north? Talking about working relationships, do you
have a working relationship with the Commission in Europe to look at a
trans-European network, for instance, linking
Mr Wyn Jones: Talking about
electrification, clearly we have got an announcement now in relation to
Q131 Albert Owen: Sticking with the North Wales Main Line, it has been on the agenda for an awful long time and my question is, is it a priority of the Welsh Assembly Government to work with Europe and the Department for Transport to get this on the agenda for sustainability reasons. We have high-speed diesel trains now and we know about fuel, electricity and energy issues in the future and, as you know, there is a plan to electrify from Crewe-Chester. Would it not be an ideal opportunity for the Assembly Government to prioritise this so that the North Wales Main Line could be completed?
Mr Wyn Jones: The reality, and we recognise it, is that the main driver has to be Network Rail because they are in charge of the majority of the funding here. Clearly it is an aspiration of ours to see that electrified, but we would need to work very closely with Network Rail to make sure they have a plan in place which is deliverable in terms of funding.
Q132 Albert
Owen: And
Mr Wyn Jones: Of course, the links with
Q133 Hywel
Williams: In the Rail Electrification Strategy Network
Rail agreed to electrify to
Mr Wyn Jones: No, I do not think we have done any assessment. No, Tim is shaking his head as well so I am on safe ground in saying that. When there is a specific proposal to electrify a line clearly the lead has to be taken by Network Rail. Well, I suppose the lead is taken by the DfT in terms of overall policy and then Network Rail will try to deliver within that. What we tend to do when there is a proposal is when Network Rail do a feasibility study we are parties to the study, so when they do a feasibility study on a particular scheme the tendency is you have a partnership approach with Network Rail, ourselves and other parts funding the feasibility study. I am not aware of there being a feasibility study on the North Wales Line yet.
Q134 Alun Michael: You referred to the Swindon-Kemble line a few moments ago. Is the full funding now secured for the redoubling of that line? Are we clear on the timetable for that work to be undertaken? You also referred to the possible electrification of that line. Is that something that is still in the air and is it something you are pursuing?
Mr Wyn Jones: My understanding is that the money which had been allocated to the South West Regional Authority, which was originally designed for a road scheme, the DfT have now agreed can be crossed over to the Swindon-Kemble line. My understanding is that the full costings have not been determined, Network Rail are still looking at the costings, but that would be a very substantial proportion of those costings I would imagine.
Q135 Alun Michael: And the timescale?
Mr Wyn Jones: As I understand it, it is reaching GRIP 4 stage in the summer. No, that is done. Perhaps you would like to give us an indication of the timescale, Tim?
Mr James: I understand that GRIP 4,
which is effectively how you deliver the final option selection, is due now or
later this month which will then inform and drive the final costs of the
scheme. Clearly we contributed part of
the funding towards feasibility. It is
important for us in
Mr Wyn Jones: I would not want to give the impression that the actual allocation currently exists for a proportion towards electrification, it probably does not. The money which has been allocated by the South West is for the delivery of the infrastructure and I do not think that would cover electrification costs.
Q136 Alun Michael: That is something you would pursue?
Mr Wyn Jones: Absolutely, yes.
Q137 Alun Michael: On your experience of working with Regional Ministers, obviously that development is an important one in terms of improving cross-border links. What is your experience so far of working with and communicating with Regional Ministers?
Mr Wyn Jones: I do not think there has been enough done in my view because the current relationships, which we are developing, are broadly government-to-government between ourselves and DfT. I am pretty sure that there will be a range of areas where we have failed to make progress on cross-border issues, particularly on roads, and we will need to improve our links with Regional Ministers as distinct from DfT ministers.
Q138 Alun Michael: That is for the future rather something you can point to experience of so far?
Mr Wyn Jones: Yes, it is.
Q139 Mr Martyn Jones: Is there a possibility that we could have a regional solution to the electrification of the Wrexham-Bidston line?
Mr Wyn Jones: Again, this depends on who pays for the scheme. My understanding is that this was a Merseyrail and TAITH proposal and there was a feasibility study, which I think we partly paid for, which showed that the cost of the electrification was around 100 million-plus, which was not affordable in relation to what people could make a contribution to. My current understanding is that both Merseyrail and TAITH are looking at other proposals now short of electrification which will improve the track in terms of reliability and frequency of services rather than electrification. I think that Network Rail have been asked to look again at the costings to see whether they can reduce them and perhaps have a scheme which is affordable and then we can come back and have a look at it.
Q140 Mr Martyn Jones: It would be very useful for people in my area.
Mr Wyn Jones: The problem with not
electrifying is that people would still have to change at Bidston to get to
Q141 Mark Williams: Good morning. Turning to future growth of use of the rail, what are your views on Network Rail's current forecasts for future growth as a guide for future investment? We have had a very impressive figure from Network Rail suggesting a 41% increase over ten years' usage on the Great Western Main Line. To your Government's credit there is progress on the Aberystwyth-Shrewsbury line, investment going there, but more generally that balance between planned infrastructure and planned investment.
Mr Wyn Jones: I am going to ask Tim to explain the forecasting criteria that are used because they are quite complex and I would like him to explain the detail. The reality is that we have all underestimated the increase in traffic in terms of rail and when the Arriva Wales franchise was agreed in 2003 it was basically modelled on a no-growth basis more or less. We have seen a substantial increase in passenger growth. It has been quite difficult for us as a Government because once the franchise was agreed on a specific sum of money and based on a specific number of passengers, any growth has to be funded by us in agreement with Arriva Trains. It has been quite difficult. I will ask Tim to give his comments on the methodology which is used, but it is not a perfect science.
Mr James: We try to model future demand
and our first starting point was in 2007 when we worked with the Department on
what was called the Wales Rail Planning Assessment which looked at a 20-year
horizon. At that point fuel prices were
very high, it was when they peaked, so clearly indicators were very strong for
future growth. Since then prices have
settled down and we have worked with Network Rail on a revised forecast, which
we have agreed with Network Rail, and it appears in the November 2008 Route
Utilisation Strategy for
Q142 Mark Williams: As an ongoing process, how are you monitoring that? In an ideal world we could still exceed even those encouraging targets. How closely is monitoring being undertaken?
Mr James: We monitor passenger numbers virtually every week on the network. There are physical counts of passengers twice a year and effectively we strengthen trains where there is some evidence of growing demand. A good example of that is where we are currently working with the Department on strengthening plans for Shrewsbury-Birmingham International. We monitor on a regular basis.
Mr Wyn Jones: Can I just say how difficult it is to forecast. As an example, at the time we were celebrating the millionth passenger on the Ebbw Vale-Cardiff line, that was the time when we thought we had reached 400,000. Forecasting is quite difficult.
Q143 Alun Michael: You have done some work on freight with the Freight Advisory Group which has looked in detail at the issues across Wales and, of course, we recently published a report on the ports of Wales in which we commented on the importance of the infrastructure from the ports both within Wales and to customers in the Midlands, and so on. What are your views about forecasting growth in freight usage? In planning for the future have you taken account of possible changes, for instance if a Severn barrage was to built on the preferred line that might lead to a big increase in usage of Port Talbot in order to be outside the barrage line? Are things like that being planned for adequately as you look at the future of freight?
Mr Wyn Jones: Freight traffic is, again, quite difficult to predict in terms of its growth because the recession has clearly had an impact on freight traffic.
Q144 Alun Michael: In the short-term, but if we want more off the roads and on rail then there has to be a plan for capacity, does there not?
Mr Wyn Jones: I understand that. What I am saying is historical forecasts will not have been borne out by events because the recession has had quite a severe impact on freight movement.
Q145 Alun Michael: For the short-term.
Mr Wyn Jones: It is quite significant
actually and some people believe it will take them a long time to recover as
well because the concessionaire for the Severn Crossing was telling us that
freight traffic is down around 18-20%, which is very significant. As people look for alternative modes it is
going to be difficult to see how that comes back. Nevertheless, you are right that you have got
to plan for future growth. Ports is not
a devolved issue for us and our view is that we should be making better use of
our ports both in terms of commercial freight and short-sea crossings to
improve our carbon footprint. The
problem we have is because ports is not a devolved issue it is difficult for us
to have a fully integrated package. I
would very much like to see working with our ports in
Q146 Alun Michael: And the associated rail infrastructure?
Mr Wyn Jones: And the associated rail infrastructure as well, yes.
Q147 Albert
Owen: I welcome the forecast increase that we have
seen, and some of us were predicting it, although there was underinvestment
decades ago that limited that growth over that period. I think the Departments are far too
conservative in
Mr Wyn Jones: The specific example you have in mind is the removal of facilities which Network Rail have. Yes, there have been considerable discussions with Network Rail to try to reach an understanding with them on a realistic costing for the proposal because that would release the potential for improving road access to the ports as well. I can tell you that those discussions are ongoing and I have held a number of meetings with Network Rail on a range of issues, of which that is one.
Q148 Albert Owen: I understand the Network Rail part of it, but is there a commitment from the Welsh Assembly Government that the money is there for that to go ahead? It is difficult to go to potential customers and say, "Do you want to use this facility?" if there is still just talk about it happening. It is difficult talking to Network Rail about anything, I understand that, but is it still a priority for the Welsh Assembly Government?
Mr Wyn Jones: It is a priority for us but we need realistic costings.
Q149 Mr David Jones: Good morning. Could we turn now to roads, please, and specifically cross-border routes, and even more specifically the A483 which has been a fraught issue over the years. Has a more strategic approach been pursued now towards the funding of cross-border schemes? To what extent are you working closely with the Department for Transport in connection with those?
Mr Wyn Jones: On the A483 section, we
regard it as a strategically important north-south route and, therefore, for us
it would be a priority. We have said
that in our Trunk Road Forward Programme and it is even in the National
Transport Plan. The problem is that part
of the road, as you know, is in
Q150 Mr David Jones: That is worrying. To what extent is the Department for Transport engaged in this problem? It seems to me that they have got a key role.
Mr Wyn Jones: They have made it clear in their response to your report that because they have devolved funding to the Regional Authority they are not prepared to intervene.
Q151 Mr David Jones: So effectively washing their hands of the problem.
Mr Wyn Jones: As things currently stand, yes.
Q152 Mr David Jones: Which must be a concern to you, I imagine.
Mr Wyn Jones: It is a concern to us because
obviously it is not just that scheme, there is also the scheme between
Welshpool and
Q153 Nia
Griffith: Haulage companies, like Owens of Dafen in my
constituency, often feel disadvantaged as compared to firms based in
Mr Wyn Jones: I recognise the issue but getting an answer to it is not quite as easy, as I have discovered. The problem you have is the actual tolls and the increase in tolls are fixed by legislation, so what tends to happen is the tolls are set and the increases are then determined by formula fixed by that legislation. I will ask Martin to explain that. My understanding is that if we were to push for a freeze or a reduction temporarily, what that would do is simply add on the years by which the repayment would need to happen.
Q154 Nia Griffith: We understand from the FTA that because there has been an increase in traffic we are well on schedule to make the repayments and, therefore, there would possibly be slack to allow some sort of freeze.
Mr Wyn Jones: Perhaps, Martin, you would like to pick that up. Is there an opportunity perhaps to ask for a temporary freeze which would not affect the overall repayment?
Mr Stevenson: I am sure there is an opportunity to ask. As I understand it, the actual increase is determined by formula based on the retail price index which is written into the primary legislation, the Severn Bridge Act 1992. If that did happen then the impact would be to push out the length that the concession ran for, so it would have to extend further than it does at the moment. Going back to what the Minister said earlier, traffic volumes are down significantly on the bridge at the moment. I guess that must be having an impact too on the length of the concession. Fundamentally, the increases are determined by the formula that is written into the primary legislation.
Q155 Nia Griffith: Has it actually been raised as an issue? Has it been explored?
Mr Wyn Jones: No, it has not by us. If people do feel that it would be an important help to hauliers that we look at that then we would be prepared to do it.
Q156 Hywel
Williams: You referred earlier on to the question of the
Traffic Commissioner for
Mr Wyn Jones: We did explore this in my
last evidence session before your Committee and I explained the reasons why we
found ourselves where we were at that time.
What we have been doing in the short-term is trying to arrange for the
Traffic Commissioner with responsibility for
Q157 Hywel Williams: Just before a decision such as having the eight Commissioners being generic would Lord Adonis have devolution-proofed that decision to consider your views beforehand?
Mr Wyn Jones: I think they had
devolution-proofed it because they agreed that in
Q158 Chairman:
Have
you thought about using the Secretary of State for
Mr Wyn Jones: Yes, we will certainly want to do that as well, no doubt.
Q159 Albert
Owen: If I could move on to cross-border links with
airports. There is an excellent service by rail between particularly North
Wales,
Mr Wyn Jones: I will be totally clear about
this: we have wanted to improve rail links there. My understanding, which is a bit hot off the
press I understand, is that extensions of services to
Q160 Albert Owen: Is there a possibility that Arriva Trains might look at the bus models as well? What worries me is that when the trains are not running there are no connections at all. I very much welcome that news, it is something that the Committee has been pushing for, that we get integration of rail. In the future perhaps Arriva could look at the buses.
Mr Wyn Jones: Obviously Arriva have a bus company and a train company but they are run as totally separate entities. I would like to see greater integration, not just between Arriva Buses and Arriva Trains but between all bus operators and all rail operators. The ideal position is that we have a fully integrated system with joint ticketing which makes it easier for people to move from one mode to the other.
Q161 Nia
Griffith: Perhaps we could turn to trying to promote
Mr Wyn Jones: Obviously the big thing on
the horizon, to be honest, is the Ryder Cup in 2010 and I know that Visit Wales
are discussing with
Q162 Nia Griffith: How much guidance are you giving Visit Wales? Is there a particular line or policy you are taking?
Mr Wyn Jones: Visit
Q163 Albert
Owen: Just to push it a little further, you are
aware of the important economic impact tourism has on
Mr Wyn Jones: I will certainly take that back to my colleagues.
Q164 Albert Owen: Integration in the Welsh Assembly Government is perhaps needed.
Mr Wyn Jones: There is quite a lot of integration.
Q165 Mr David Jones: How is your office working with the Department for Business in promoting UK-wide schemes in the Welsh context for addressing the problems caused by the recession?
Mr Wyn Jones: Quite a lot actually. The main point of contact that we have with
BIS is not directly through one of their ministers but through the Secretary of
State for
Q166 Mr
David Jones:
Mr Wyn Jones: I am not in a position to give that kind of assurance, I am afraid. We do not know is the truth. The pattern of labour market statistics in Wales has been quite interesting in the sense that there were many more job losses in Wales in the early days, then it seemed to have flattened out and there were periods during which the level of unemployment in Wales actually dipped below the UK level, but in the last two months it has gone back up again. It is quite a difficult predictor.
Q167 Mr
David Jones: The statistics do not look very good from a
Welsh context. You will be aware of the
ONS regional figures last week which showed that
Mr Wyn Jones: I am here today as a Government Minister. We have recognised that we need to look at some of the policy levers that we are using. Let us be honest about this, we do not have the major macroeconomic levers within the Welsh Assembly Government. What we have to do is to use the resources that we have very creatively indeed. What we have done is we have launched the Economic Renewal Programme which is looking at all the policy levers that we have with the aim of moving up the supply chain so that when we come out of recession we are better positioned to capture the investment as it goes forward. I think the Economic Renewal Programme will be addressing many of the issues that you have raised.
Q168 Mr
David Jones: Is it fair to say that Objective 1 has been a
missed opportunity in
Mr Wyn Jones: I am not in a position to respond to what previous ministers did. All I can say is that the convergence programme which currently is being run by WEFO understood the need to have much more strategic projects to go forward. For example, I think we are now around 40 or 50 projects which have delivered a billion pounds of funding, whereas under the previous scheme we were probably talking about a few thousand. It is a big change. Convergence is much more strategic in its approach.
Q169 Albert Owen: I understand you are not here to answer for individual areas, and particularly Anglesey, but do you not agree that the ONS statistics do not take into account the recent Government intervention, both at Welsh Assembly Government level and at a UK level, and indeed the relatively low GVA in Anglesey and North West Wales is historic because of the depopulation in the 1980s and 1990s?
Mr Wyn Jones: I do not want to get into that sort of discussion. Looking at it from a completely Welsh perspective there are challenges here, which I think we all accept. Those ONS figures are lagging figures in some senses because they do not show the today figure, as it were. The Economic Renewal Programme which we have initiated does indicate that we are prepared to look quite radically at the policy levels that we want to use going forward because we all accept that following the end of the coal and steel industries as we then knew them and the investments from other countries in the world, particularly Japan, in the 1970s, 1980s and 1990s, that era is probably over and we need to look to the future in a different way.
Chairman: Minister, thank you very much for your
attendance today and for the efficient way in which you have answered your
questions. You will be aware that we
have five ministers before us today and we are particularly delighted that we
have three from the Welsh Assembly Government and are looking forward to their
evidence later on. Could I wish you all
season's greetings. Thank you.
Witnesses: Chris Mole MP, Parliamentary Under-Secretary of State for
Transport, and Mr Stephen Wolstenholme, Acting Divisional
Manager, Rail Support & Communication, Department for Transport; and Rt Hon Jim Knight MP, Minister for the
South West, gave evidence.
Q170 Chairman: I understand that the Minister is on his way but, because time is tight, Minister, would you introduce yourself for the record, please?
Jim Knight: Jim Knight, as accurately portrayed Minister for the South West. I am delighted to appear before you renewing the double act that Chris and I performed in front of the South West Select Committee last week, and I am sure it is a double act that will deliver in time.
Mr Wolstenholme: I am Stephen Wolstenholme. I am Head of the Rail Support & Communications Division at Department for Transport and my responsibilities include embedding devolution in rail matters and promoting relationships with the Wales Office and the Welsh Assembly Government.
Q171 Chairman: Thank you very much for that. Could I begin, Minister, by thanking you for those introductions and ask you a very simple, straightforward question. How often do Regional Ministers meet with Welsh Assembly Government Ministers and what are the issues that they discuss?
Jim Knight: Partly because of the
Q172 Alun Michael: You referred to the Severn Estuary proposals. There were meetings not only with Welsh Assembly Ministers but also Members of Parliament in constituencies around the Severn Estuary and that has not happened for a year or more. Is it your plan to reinstitute what were very useful meetings?
Jim Knight: I am sure if the constituency Members concerned thought them useful then that is something I can pursue both with the minister in DECC and my colleague in the Welsh Assembly Government. Obviously getting the three of us in one place at the same time can occasionally be a logistical challenge, let alone marrying that with the diaries of Members of Parliament, but if we can cover it off between us, yes.
Q173 Alun Michael: It was a ministerial initiative by Malcolm Wicks originally and it was very useful because, of course, it cut across the different interests of quite a diverse group.
Jim Knight: I will certainly raise that on Thursday with the other ministers and see if we can get agreement to do that.
Q174 Mr Martyn Jones: What was your role in securing the funding for the Swindon-Kemble line and has full funding been achieved now?
Jim Knight: This has been probably the
best example in the five or six months that I have been Regional Minister of us
effectively working together and using the Regional Minister role to secure
funding for a project that clearly is of importance beyond the region, in
particular to Wales. This was something
that was raised very strongly with me both by the Member for Stroud, by Members
from my region in the Grand Committee that we held in
Mr Martyn Jones: That is very good news for us
in
Q175 Alun Michael: Could I just make sure that I have understood that last answer. So not only the funding and the development of the Swindon-Kemble line but also its inclusion in electrification is now part of what is being planned.
Mr Wolstenholme: Chairman, could I just clarify on that point the links between electrification are as a diversionary route and increased use of that diversionary route during the electrification process. As we have heard in earlier evidence from the Welsh Assembly Government, the proposal is not to electrify the diversionary route and, as we have just heard, it is very important that the price of this project comes in at a level which reflects affordability and the funds available. It is important not to tip that careful balance by expanding the project and making it unaffordable.
Q176 Alun Michael: That is understood. As I understand it we will have the redoubling of the Swindon-Kemble route which will give the capacity which currently is limited, which is a particular problem when there is repair work or whatever going on on the main line. Accepting that this is looking further into the future, if there is electrification the use of that diversion would be difficult post-electrification, would it not, unless that is electrified too?
Mr Wolstenholme: The proposals for the new
rolling stock to serve the South Wales Main Line would be what we call bi-mode,
so they would have principally electric traction but the ability to run in
diesel mode. That is important for a
number of reasons, not only for use on diversionary routes but for services
beyond
Q177 Alun Michael: So there would not be a problem with making sure there was full use?
Mr Wolstenholme: I can confirm that the services from the South Wales Main Line would be able to use the diversionary route after it is electrified.
Jim Knight: As South West Regional Minister I am keen that we have that hybrid rolling stock, if you like, so instead of continuing on the excellent journey into Wales that goes on down into the South West, they can use the electrification up until Bristol and then go down under diesel power.
Q178 Alun
Michael: You underline our complementary interests very
well. On the situation with the
electrification, what stage have we reached?
Have contracts been signed and, if not, what is the timetable for that
to take place now that we have had the firm announcement? Do we know a date of completion for the line
west of the Severn Tunnel? Is the
technology okay for electrifying the tunnel?
Finally, are there any other electrification schemes being considered in
and out of
Mr Wolstenholme: Chairman, I can confirm that
following the announcement by the Prime Minister in July about electrification,
the Government has been working closely with Network Rail since to develop the
detailed specifications for this work.
The electrification needs to be planned carefully so that it can be
delivered in the most efficient way to keep costs down and, very importantly,
to minimise the disruption to passengers.
We have shared with Welsh Assembly Government rail officials the draft
specification for the works and invited their comments on them. To give you a little bit of the flavour of
this, this concerns how much of the route would be electrified in terms of
extra sidings, links to freight depots, the sort of detailed working that has
to be done to translate the broad approval into a practical scheme. I also confirm that the electrification would
be done in a single process from London-Swansea, it would not be staged as
perhaps there were some rumours earlier that work would go to
Q179 Alun Michael: The timescale?
Mr Wolstenholme: Could I come back to remind myself on the completion date.
Q180 Alun Michael: It is the timescale and when contracts will be finalised.
Mr Wolstenholme: The timescale will be as announced by ministers when they announce the journey time improvements of about 19 minutes on the London-Swansea service.
Q181 Nia Griffith: Can I ask for some clarification on that. When you say it is going to be done as a piece, as it were, does that mean there would be simultaneous works in the different parts? Can you explain how that fits in with what Lord Adonis has previously said about the hybrid creature which will mean you will not have to change, jump out at Bristol and get on to another train when this process is partly complete?
Mr Wolstenholme: The detailed planning and
delivery of this scheme is the responsibility of Network Rail and not the
Department. Given the announcement was
only made in July, I am not in a position to describe the detailed execution of
the work. I can confirm that it will be
done as a single rolling programme. In
answer to the question about rolling stock, as I said earlier, the stock will
be dual mode and passengers will have a seamless through journey. The trains will convert to diesel mode for
travelling west of
Jim Knight: As Regional Minister, part of my role is advocacy as well as representation, so I advocate to the Government as well as representing the Government. More with the advocacy side, what I would be keen to see is the project is planned in such a way in sequence so that Swindon-Kemble work can be done prior to the need for the electrification in the Severn Tunnel because that would smooth things considerably for passengers wanting to get to and from Wales.
Q182 Chairman: Mr Mole, welcome, belatedly. Could you introduce yourself for the record, please?
Chris Mole: Chris Mole, Parliamentary Under-Secretary at the Department for Transport.
Q183 Hywel Williams: Can I ask you about the possibilities of a second rail or transport crossing using the possibility of the Severn Barrage. I understand that this is not being considered at present, although this Committee is very keen to see it considered. Could you tell us why you are not considering it?
Jim Knight: I do understand the
Committee's enthusiasm. This is a multi-layered response. First of all, in respect of the
Q184 Hywel Williams: Can you tell the Committee whether you are absolutely confident about your projection of need? We did hear in earlier evidence, for example on the new Ebbw Vale line, that at the point where it was expected that 400,000 passengers would have used that line, in fact one million had. That was in a fairly short timescale and here we are looking in terms of decades. Are you confident that you can make these decisions based on the supposed economic circumstances decades ahead? I realise this is a difficult question.
Jim Knight: You will appreciate that I am
extremely enthusiastic about the movement between
Q185 Hywel Williams: Neither am I.
Jim Knight: They have shown that the existing links have the capacity to meet the forecast increase in demand over the next two decades. For us then to start to try and plan and project in terms of what the economy needs and socially we need in transport beyond the next two decades starts to get quite brave. The important thing for people is if a barrage - and it is a large if - is built it would probably be in place for hundreds of years and if new transport links were needed beyond 2025/30 then you could look at the barrage and look at what would be possible using it.
Q186 Chairman: Could I come to you now, Mr Mole, and ask you the straightforward question, what is the relationship between the Welsh Assembly Government and the Department for Transport? Has it improved over the last year? I know that you have not been in post for a full year, but in your period could you describe the relationship and give an assessment of whether or not it has improved.
Chris Mole: My understanding is we have very good working relationships with the Welsh Assembly Government and the benefits of this joint approach have been experienced by rail users across the country.
Q187 Mr Martyn Jones: Could a regional solution be found to fund the electrification of the Wrexham-Bidston line in North East Wales?
Chris Mole: Sorry, could you repeat that question?
Q188 Mr Martyn Jones: We have a line which crosses the border which is very useful to people in my area.
Chris Mole: Wrexham-Bidston?
Q189 Mr Martyn Jones: Yes. Have you any idea of the regional solution that could be found? We have had some information from the Minister for the Assembly that there have been discussions with TAITH and the Assembly Government and Network Rail seems to be dragging their feet on this. I wondered if you were aware of the negotiations and how you think they have been going.
Chris Mole: The Department's perspective is that for schemes which are essentially of local or regional priority, we expect the regions to bring forward schemes in order to demonstrate that they have demand sufficient to support them for a number of years before we will look at including them in the franchising process, and so the priority, as we see it, is to demonstrate the additional flows of passengers that would benefit from further works on the line. The starting place for that is with the Welsh Assembly Government, who specified the franchise for Arriva Trains Wales, and they would really be the people to be doing that because most of the infrastructure is actually in the North West England region. We anticipate that it would have to be them that brought forward proposals through their regional funding allocations in order to make changes to the infrastructure on that line.
Mr Wolstenholme: Chairman, can
I just add that we do work very closely with all the related interests
here. That includes Mersey Travel and
the regional consortia of local authorities in
Q190 Albert Owen: Network Rail talk about 3.3% annual growth forecasted for the
future. This compares less with the
franchise in
Chris Mole: We are working our way through the first what is called High Level Output Specification across the country for recognising the increased capacity that we need on the rail network. The railways is the sort of service that is faced with the problems we like, ie too much demand. It is much better to be in the situation where we have got more passengers rather than a declining number of people using the railways. The 2007 White Paper put the High Level Output Specification process in place, which we then fund through the railway franchisees and through Network Rail to provide both the capacity in terms of rolling stock on the infrastructure and, necessarily, to provide the flows of rail vehicles around the network. As I say, we are in the first stage of that now. It has just started with Network Rail's Fourth Control Period, and that is delivering additional capacity across the country, as I say. There will then be a second round of that HLOS2 which will hopefully extend in the same sort of way as additional demand is identified. Mr Wolstenholme would like to add something to that.
Mr Wolstenholme: I can confirm
as well that subject to the current forecasts we expect the capacity
improvements in the
Q191 Albert Owen: You have touched briefly on it and we all welcome the increase in
passenger numbers, rolling stock and infrastructure. The one gap that I see is maintenance and
wonder if your Department could answer this or certainly look into it. In my area where we have improved the
frequencies of trains with Virgin from
Chris Mole: Are you talking about ---?
Q192 Albert Owen: A rail depot in
Mr Wolstenholme: As regards
the question of maintenance facilities at Holyhead, the maintenance strategy
for the Virgin train service in
Q193 Nia Griffith: When we were talking about electrification,
obviously we had the opportunity to speak to officials but I really would like
to pose this question to the Minister if I may. There seems to be an artificial divide in
cutting off at
Chris Mole: In terms of
electrification what we do is we look at where the passenger flows are highest
where the inter-city services can meet that demand. I think it was very welcome, to be honest,
that the electrification ran through from
Q194 Mr David Jones: Could we turn to roads now please.
The previous witness, Mr Wyn Jones, the Welsh Transport Minister,
expressed some frustration that decisions about routes of importance to
Chris Mole: Ever since we
established the regional funding allocation process it has been our view that
we should devolve those decisions to the regions in order to take their advice
on what the priorities within their regions are. We would hope and expect them to have a
dialogue with neighbouring regions and nations such as would be the case
between South West region and
Chairman: I am conscious of time and we will need to write to the Minister to add further questions. Mr Mark Williams?
Q195 Mark Williams: I want to turn now to
the Severn toll and ask whether your Department has considered at any point
freezing or reducing tolls on the
Chris Mole: I understand
that the primary legislation is different and that the Department has no locus
in setting the tolls on the
Q196 Hywel Williams: Turning to the Traffic Commissioner for
Chris Mole: I think I will have to write to you on that one, Mr Williams.
Q197 Hywel Williams: Can I also ask you about cross-border links to Liverpool and
Chris Mole: I had
understood that the decision on running a train through to
Albert Owen: Running well.
Q198 Hywel Williams: Can you tell us about
transport links to
Chris Mole: To
Chairman: Mr Jones, I cut you off in your prime earlier.
Mr David Jones: I am not taking offence, Chairman.
Chairman: Would you like to ask that supplementary now?
Q199 Mr David Jones: The point I was going to make, Minister, is that the A483 is a particularly important route in a Welsh context and it is simply not working at the moment. We had evidence from the Welsh Minister just before you arrived to the extent that he is intensely frustrated at the fact that that route cannot be developed. I would hope that your Department might have an overarching influence in terms of influence rather than direction upon the regional authorities.
Chris Mole: I will certainly raise it with the Regional Minister but, as Mr Knight will tell you, regional ministers have to tread a little carefully in not over-directing our colleagues within the regions as to what they should prioritise within their RFAs. Very much in the way I am sure the Welsh Assembly Government would not take too kindly to us telling them what to do.
Q200 Mr David Jones: I think they want to talk to you.
Chris Mole: We are always happy to talk to people.
Chairman: Mr Owen, do you wish to ask a very brief supplementary?
Q201 Albert Owen: I was cut off and it is on that theme of joined-up government on these issues. Regarding the rail depot we have had the Minister from the Welsh Assembly Government saying it is Network Rail and we have now had the Department saying it is the customer. At the end of the day this is an on-going project and nothing is happening so where does the buck stop?
Mr Wolstenholme: The maintenance of the trains is a matter for the train operator. That takes place in facilities that are owned by Network Rail. If the train company wishes to expand the amount of maintenance that it undertakes at Holyhead as opposed to another depot, Network Rail would need to expand those facilities or relocate them to another site within Holyhead. It would expect reimbursement and a like-for-like replacement if that depot was to be moved. If the depot was moved I understand that that would then facilitate the highways schemes and that is a matter for the Welsh Assembly Government.
Albert Owen: It is as clear as mud.
Q202 Chairman: Thank you for your attendance today.
We greatly appreciate you being here and answering our questions very
openly and frankly and very comprehensively.
Mr Mole, I understand that you intend coming to
Chris Mole: Okay.
Chairman: Thank you very much.
Witnesses: Mrs Edwina Hart MBE, Assembly Member, Minister for Health and Social Services, Dr Mark Drakeford, Special Adviser, and Mr Paul Williams, Director General, Health and Social Services, Welsh Assembly Government, gave evidence.
Q203 Chairman: Good afternoon and welcome to the Welsh Affairs Committee. Minister, can you introduce yourself for the record and your colleagues please.
Mrs Hart: My name is Edwina Hart, and I am Minister for Health and Social
Services in the Welsh Assembly Government.
On my right is Paul Williams, who is Director of the NHS in
Q204 Chairman: Thank you very much and welcome again. We have had the Department of Health saying to us that the revised Protocol for cross‑border healthcare commissioning has, in their words, "resolved the most significant and public cross‑border issues" we identified in our own report. Do you agree with that statement of the Department of Health?
Mrs Hart: Can I say, yes, we very much agree with the Department of Health. We have had excellent relationships with the Department of Health, both at ministerial and official level and we do find that the Protocol is working very well, but obviously we keep looking at the Protocol all the time with our colleagues in the Department of Health to see if there are any further improvements that need to be made.
Q205 Chairman: We welcome that statement. What would your response be to reports of people who are still being refused treatment across the border?
Mrs Hart: I am not aware of any specifics. These are obviously operational matters for the NHS. I am not aware if the Director knows of any specifics at all that have been drawn to our attention at the centre. Obviously it is up to local health boards to resolve these matters. I think they are few and far between bearing on the information that might come to me in terms of Members' correspondence.
Q206 Mr Martyn Jones: Good afternoon, Minister. We are really pleased to see you here. We thought you did not like us, or something, the fact it took some time to get you here. Going on on the issue of the Protocol and whether it is working or not and whether it is being monitored, I spoke to somebody yesterday, in fact a constituent of mine, who has had the experience of going to Robert Jones and Agnes Hunt in Gobowan across the border for specialist treatment there and she was told ‑ this is within the last two months ‑ that she had to wait 40 weeks for treatment because she was from Wales and that the waiting list in England for the same treatment was 18 weeks. She mentioned my name and it went down to two weeks. I am not saying I have a magic wand in these circumstances but it is rather odd that she was given two such disparate lengths of time if the Protocol is working. How is the Protocol being monitored and what is the degree of transparency on that monitoring?
Mrs Hart: I might say that we too have anecdotal tales about what people are
told by individuals who work in the English NHS. Obviously I am not responsible for the
English NHS in terms of what people say.
Of course in terms of waiting times from the point you come into the
system to the end in
Q207 Mr Martyn Jones: It is a bit odd if the Protocol is working and the system is not working. If the Protocol is there and is supposed to be working, then who is monitoring whether it is working? Is it yourself? Is it the Department of Health? Is it the local or regional health boards? What is happening there?
Mrs Hart: It will be the local health boards that have the responsibility in that area. In terms of the new health boards of course three of them do go along the border. We have told them that they have to make sure that they monitor it properly and take into account any complaints or issues that are raised.
Chairman: Mr Owen, you wished to ask a supplementary.
Q208 Albert Owen: Good afternoon, Minister. Just for clarity on that, if we have evidence coming from our constituents that they have been told by either the hospital across the border or the LHB that the waiting list does not concur with this Protocol, you are suggesting we write to yourself as the Minister?
Mrs Hart: Yes, I would be delighted to take it because then we can get a global look at the situation from the anecdotal information that is coming in via MPs and AMs. It would be most helpful for us.
Q209 Albert Owen: So bypassing the LHP and directing it at yourself?
Mrs Hart: I think that might be helpful in the first instance as this is a Protocol between government departments or the Welsh Assembly Government and Department of Health. I think that would be most helpful for me as a Minister.
Q210 Albert Owen: Because at the end of the day we are all looking for solutions.
Mrs Hart: Yes.
Q211 Mark Williams: Can I just ask how your Department works with the Ministry of Defence in terms of providing treatment for Armed Service personnel? Are there any differences in treatment that servicemen could expect on either side of the border?
Mrs Hart: Can I say we have been delighted to be associated with the Government's initiatives in the MoD about dealing with the issues around veterans particularly, and Service personnel. Of course, if you are a member of the military, you retain your rights on the waiting list, irrespective of where you go in terms of service. We have been associated with all sorts of initiatives as part of the Government's initiative in dealing with veterans across the piece.
Q212 Mark Williams: How many meetings with yourself and your other officials, do they have regular meetings with the Ministry of Defence?
Mrs Hart: Yes, there have been regular discussions and correspondence and we have found the MoD particularly helpful and open in their dealings with us about what we consider are the issues.
Q213 Chairman: We welcome your statement
about that and particularly in the present circumstances with the war in
Mrs Hart: Absolutely.
Q214 Chairman: Given all of that, have you met with the Veterans Minister and, if so, how frequently?
Mrs Hart: We have had some difficulties in organising meetings with the
Veterans Minister and my officials have been in touch with the appropriate
officials in the various departments.
Obviously in terms of issues on veterans we have pursued a very vigorous
policy in
Q215 Chairman: We certainly welcome that statement. Given also the fact that we have now a number of administrations - Scotland, Wales, Northern Ireland - would you welcome an initiative, perhaps you might take the lead, in ensuring that all the administrations come together to discuss issues around the veterans' issues and perhaps it could be convened by the Veterans Minister?
Mrs Hart: I have to say I think that is a first-class idea because I think it would be helpful for us to have those type of discussions across the piece. We find enormously helpful our health ministers' meetings now, particularly on the issue of pandemic flu, and veterans' health needs would also be a very useful discussion for health ministers to have collectively and ministers with responsibility for veterans, because I think it is quite clear now that when you speak to the public, they are very concerned about the needs of veterans. We have seen more of them coming home and they recognise that more services need to be provided in a very integrated format.
Q216 Hywel Williams: Good morning, Minister. Can you tell us a little bit about the treatment of post-traumatic stress disorder for veterans? There has been a well publicised case in North Wales recently where a specialised unit set up by charitable efforts had to close and there was a great deal of dissatisfaction expressed about this. I do not think that was a responsibility directly of your Department in any way but do you have any observations on that?
Mrs Hart: No, I think we are slowly getting to grip with veterans' issues
within the National Health Service in
Q217 Alun Michael: I am sure you are aware
that there is a draft Directive on cross-border healthcare which is currently
under discussion within the European Union.
That draft Directive would enable patients from
Mrs Hart: Well, of course there are two different systems across the borders in terms of how treatment is paid for and everything and we have the necessary care pathways go across our borders automatically. We just have this administrative arrangement in terms of the Protocol about what payments are given to us.
Q218 Alun Michael: Yes but that arrangement
exists between the
Mrs Hart: I would not think so because the European draft Directive on Patient Mobility is a draft Directive I understand currently and has no direct impact on the England/Wales situation. Can I make the point about the European draft Directive on Patient Mobility. We have had excellent discussion with English ministers who are taking this forward in terms of the contact at health level with the previous Minister, Dawn Primarolo, and the current Minister and we have been properly included in all discussions, I have to say, with the Department of Health on these European issues.
Q219 Alun Michael: I am delighted with that which is the answer to my next question which I have not asked yet. That does entirely cover the question of liaison. Coming back to the issue of the requirements on patients, is there not going to be something rather odd from the patients' perspective if they could make a choice to go to France or Germany for treatment without prior authorisation from the NHS, but not in relation to the English/Welsh border? I take your point entirely that the two are not related in legislative terms, but in terms of practical arrangements that patients understand is there not a need to look at refreshing those arrangements in the light of the Directive that is likely to emerge?
Mrs Hart: I do not think we should
confuse the two. I think we have got to
be quite clear that patients are treated in
Q220 Alun Michael: Would you accept that it needs some explaining for patients to understand the differences?
Mrs Hart: I think sometimes when you look at the NHS as a whole it needs some explaining sometimes to patients in terms of where they must go.
Q221 Alun Michael: I agree with that.
Mrs Hart: Of course the Wales Audit Office this morning has looked at unscheduled care and I think sometimes it is difficult for patients to understand where out-of-hours services are, whether they should go to NHS Direct, should they pop into an A&E, and I think that is one of the issues that affects all UK Government health ministries where the most appropriate point is and what information you do give to patients, so I think that is a point well made.
Q222 Albert Owen: What mechanism does the Welsh Assembly Government have in place for
any future administrative changes in
Mrs Hart: Can I say when we talk about changes, payment by results and tariffs, they are actually all changes in English policy which we have tried to accommodate with our arrangements with the Department of Health, not them accommodating us, may I say, and we do keep a very close eye on any changes. We do not want any unintended consequences at all and that will be the job of LHBs, particularly on the borders, to look at what issues might arise across the borders and they then need to report into us about whether we then need to raise issues with the Department of Health.
Q223 Albert Owen: Did I hear you right that they do not always liaise with you? Is that what you said of their administrative changes? We understand in the new year that there is a new group going to be set up. What will be the input of the Welsh Assembly Government in that to avoid the circumstances that you have described?
Mrs Hart: We have all arrangements at official level and we have very good relationships at official level in Departments of Health on all changes that do occur and that they are contemplating.
Q224 Albert Owen: So when there is a policy change in either the Welsh Assembly
Government or the Department of Health, or even at the local board levels in
Mrs Hart: If we thought there would be any possible impact, yes.
Q225 Albert Owen: Okay, and do you see ministerial involvement in that?
Mrs Hart: Some of these are operational matters obviously for the NHS. If there are policy issues I am consulted readily by the Department of Health about policy issues that might impact on us. We do have good arrangements with the Department of Health ministers.
Q226 Albert Owen: The response from the Department of Health Minister to us to our
first report talked about local cross-border models and mentioned the
Mrs Hart: If I can hand over to the Director. It is an operational matter.
Mr Williams: The cross-border group works collaboratively across the three
strategic health authorities that are on the border with
Q227 Albert Owen: That is very helpful, thank you.
So would you say that the working model of Central Wales and
Mr Williams: This arrangement is peculiar to the border area.
Q228 Albert Owen: So in the other border areas a similar working group would be set up?
Mr Williams: Yes.
Mrs Hart: We have asked the Local Health Boards to look particularly at their cross-border arrangements now because they have only been formed since 1 October and we do not want to loss any of the expertise they might have had previously within them now as we go into a new structure to make sure they are really on top of the issues here.
Mr Williams: If I may, we have an internal meeting in the next couple of weeks
with the new health boards in
Q229 Chairman: Could you raise your voice please.
Mr Williams: In
Q230 Albert Owen: Following on there will be regular meetings with groups across the border?
Mr Williams: Absolutely, which are quarterly.
Q231 Mark Williams: I think that answers my question but I will ask it nonetheless, the question being: what would the impact on cross-border provision be with the amalgamation of the trusts and LHBs into the three multi-purpose bodies serving North, Mid and South East Wales. Do you have anything to add on what you have just said in terms of ongoing meetings? You are hoping obviously to pre-empt any difficulties that may emerge later on.
Mrs Hart: I do not think there is anything to add really.
Q232 Mark Williams: Thank you. The second question was the likely impact on cross-border services of the reshaping of primary, community and mental health services in each country. As that agenda rolls out, do you envisage any particular difficulties on cross-border issues?
Mrs Hart: None whatsoever.
Q233 Mr Martyn Jones: The ludicrous proposal that patients in North Wales who require specialist neurologist services should travel to South Wales rather than across the border to Liverpool has now gone, thanks in part to Mr James Steers, but how will any replacement arrangement for Health Commission Wales ensure a consistent, equitable, responsive and timely approach in the future to the provision of cross-border specialist health services?
Mrs Hart: Of course we have now had the full neurosciences report which has now become an operational matter for Betsi Cadwaladr in the north to put in the provision of the necessary services which will be dealt with closer to home in certain areas and we are continuing our existing arrangements at Walton. I see the demise of HCW as something that I am absolutely relieved about because there have been so many difficulties with the organisation around commissioning issues, patient issues, and I am very pleased that we are going to our new arrangements. Obviously we will have a few central issues that we will retain at the centre with what I consider to be the daughter of HCW and they will deal with the very specialist end, but I think the new arrangements between the new LHBs will work very well because they are practical people, they are used to dealing with these patient issues on the ground, they are used to patient care pathways and I think that will be much easier for patients to understand.
Q234 Mr Martyn Jones: That is encouraging. The
Department of Health has told us that "the National Specialised Commissioning
Team has had discussions with colleagues in
Mrs Hart: Obviously this is an operational matter within the NHS. Paul, I do not know whether you have got anything in terms of the answer to the question.
Mr Williams: There has been a regular dialogue with our Health Commissioner in
Q235 Mr Martyn Jones: Have you made any progress towards a common commissioning system? Obviously you have ongoing discussions when you discuss individual cases and types of diseases and whatever that this might apply to, but is there any progress towards a common commissioning situation?
Mr Williams: As such in the sense that we have a common purpose in order to engage in those discussions when we have a particular group of patients that require specialist care. Sometimes the approaches can be different depending on specialty but we are always looking for best practice.
Q236 Mr Martyn Jones: Do you think that the current financial climate will make it harder for patients to secure authorisation for expensive specialist treatments across the border?
Mrs Hart: We work on the basis that if the clinicians say that treatment
should be given to individuals, it will be the clinician's decision. We might be in difficult times financially
but we also have to recognise that if patients require treatment and clinicians
think it is worth doing, we must always accept that clinical lead. It is very difficult when we talk about
money. We have only got to look at the
issues surrounding NICE in terms of drugs and everything. There are very difficult decisions that
Ministers across the
Mr Martyn Jones: Thank you, Minister.
Chairman: Albert Owen, you want to ask a supplementary and then Mr David Jones.
Q237 Albert Owen: We do not want to go back in history but do you think there was a need to have the Steers Commission and review looking into it when you stated earlier on that there was a natural pathway between people in North Wales going to their general hospital, as I still refer them to, and then for specialist treatment across the border in Liverpool and Manchester? Do you think there was a need for a review?
Mrs Hart: I have to say I think it is the best thing I have ever done in terms of a review because it has given clarity to services within North Wales and certainly clarity to services within South Wales, where we had some very difficult issues between Cardiff and Swansea, of course, regarding neurosurgery which have now been successfully resolved. The good news about the Steers Review is that the new services are now much closer for people with Parkinson's Disease, muscular dystrophy, multiple sclerosis and stroke, and those will be closer to home and they will be safe services. If out of that comes improvement in patient care I really value the work that James Steers undertook. Of course, it was a very difficult time because people are always upset when you talk about service change. At the end of the day I think we have got the best of both worlds and enhancement of services.
Q238 Albert Owen: If I may come in, that is the important thing. You are suggesting there was going to be no
service change, that there was going to be the national pathway across the
border for the specialist service anyway, and it is that statement that caused
the anxiety for many of my constituents and constituents in
Mrs Hart: I do not think it is helpful, Chairman, to go back historically because my statement was quite clear. There were a lot of things said around my statement that did not necessarily affect the tenor of the debate within the National Assembly.
Q239 Mr David Jones: Mrs Hart, I read your
statement in the Assembly very carefully and what you said was that you
proposed to arrange for all elective neurosurgery generated in
Mrs Hart: Can I say we have a national Health Service in the
Q240 Mr David Jones: With respect, Mrs
Hart, you were apparently expecting sick North Wales patients to travel in the
back of an ambulance down to
Mrs Hart: I think we need to go back and read my statement on this. I do not want to go back into the history of it.
Q241 Mr David Jones: I have read it very carefully.
Mrs Hart: I can say that as far as I am concerned, Chairman, now the neurosciences issue and the whole of the issues have been satisfactorily resolved. Clinicians are happy and patients are happy. I see no point in putting any more consternation into the system or upsetting anybody now or in the future.
Q242 Mr David Jones: With respect, you caused the consternation, Mrs Hart.
Mrs Hart: Well, that is a matter of opinion.
Q243 Mr David Jones: Would you say, Mrs
Hart, that patients living close to the border are generally aware of the
implications of choosing a GP either in
Mrs Hart: I would say that patients make the choice they want in terms of GPs, which is the most accessible surgery for them, generally I would think.
Q244 Mr David Jones: Does the Welsh Assembly Government take steps to explain to patients the consequences of choosing a GP on one side of the border or the other?
Mrs Hart: I think that patients are aware of the benefit of free prescriptions and the ease with which they can get them when they have a Welsh GP. They obviously have an entitlement card if they have an English GP and are a Welsh patient. Of course, we have now resolved the issue about payments that used to happen in the trusts with medicines because we have got new regulations from October 2009, so all those matters have been resolved. GPs, can I say, is very much a matter of personal choice. As an individual myself I like my practice, even if I moved house I might like to stay with my existing practice, and I think people make a lot of decisions on the basis of how they feel about the practice and how close it is, how accessible, and how warmly received they feel when they attend the practice.
Q245 Mr David Jones: Does the Welsh Assembly Government measure the effectiveness of efforts to promote patient awareness of the consequences of choosing a GP on one side of the border or the other?
Mrs Hart: I think in terms of the Welsh Assembly Government we are very conscious of what a patient wants and patients' rights. Of course, we retained in Wales Community Health Councils to ensure that patients did have a voice and understanding. I know particularly within Powys, which currently has two Community Health Councils, I am sure these are issues that are readily raised perhaps with Community Health Councils. We have seen nothing specific obviously in terms of these issues about whether we need to do further work. I think it is an area we might want to do further work, but enhancing patient knowledge and understanding about services is something that we all look to enhance. It is one of the issues Community Health Councils do raise with me. We have considered perhaps a website of information for people cross-border and others and those are issues that are ongoing in terms of discussion.
Q246 Mr David Jones: To what extent do the Welsh Assembly Government and the Department of Health co-ordinate their efforts to promote public awareness on public health matters such as, for example, the current swine flu outbreak?
Mrs Hart: Can I say that we had the most excellent relationships with the Department of Health across the four nations on the issue of swine flu. We have regular health ministerial meetings probably about once a week where we go through all the public health issues. We have co-ordinated publicity on the public health agenda. We have co-ordinated our programmes in terms of vaccination on the public health agenda and, to be frank with you, it has been a model in terms of the work that we have undertaken.
Q247 Nia Griffith: Could we look now at the
opportunities offered by devolution for things to develop in different ways in
the different home nations. Do you feel
that there have been opportunities there where the other home nations have
learned from
Mrs Hart: I think we all learn from each other. We have to understand that in
Q248 Albert Owen: Just on the differences between the home nations, do you agree that there is a lack of comparative data between the four nations? In particular, when we are looking at waiting list times some of the arguments have been over policies and yet it was very difficult to get comparative data on these issues. Again, if I may say, in previous evidence sessions the Department of Health has talked about working with yourselves and getting research between the different nations. Are you aware of this and is the Welsh Assembly Government going to participate and, if it does not happen, take the lead in it?
Mrs Hart: Yes, we obviously work with the Department of Health on a wide range
of issues. Of course, it is a bit like
apples and pears, you are quite right, in terms of looking at the differences. I have a referral to treatment patient target
of 26 weeks which is an open pathway and that is from start to finish. The Department of Health has an 18-week
closed pathway for with a 10% tolerance level.
For instance, in terms of cancer targets we have the same targets but I
actually have therapy targets which the Department of Health does not have of
14 weeks, so we are different and we have just looked at where we are in terms
of what we are doing. However, I think
it is important that we do learn from each other about where there has been
good practice there. I am not averse
wherever good practice comes from in adopting it and I think you will find that
any of the
Q249 Albert Owen: I understand that basic point and I agree with you, but there is a lack of comparative data, and you accept that, so what steps is the Welsh Assembly Government taking to make sure that that data is available, particularly for cross-border patients? You mentioned choice earlier on, so that they are making the right choices. Without the proper data it is very difficult to make the choices.
Mrs Hart: I think there is data available. You are probably talking about the accessibility of it and whether we should do more on that issue, and that is something that I am more than happy, Chairman, if the Committee comes out to look at these issues, obviously to look at them myself again.
Q250 Albert Owen: Okay. Again, going back to what the Department of Health said that they wanted to discuss with yourselves about commissioning this research, do you know if they have proposed this officially and what is the response from a Government level?
Mr Williams: I have not had any approach on this. I know the Nuffield Institute has been doing some work on comparison of healthcare across the devolved administrations, but I have not seen anything come formally from the Department of Health.
Q251 Albert Owen: Okay. The last question again, Minister: if this is ongoing, you will participate in it and you might even take that further and commission it from the Welsh Assembly Government?
Mrs Hart: I have got some research going on currently on cross-border issues within my own Department and within our own area, which I think will form the basis of anything we do. I cannot say yes to any questions because I always have to look at the financial implications for my budgets of any requests for me to do any joint working in the future.
Q252 Albert Owen: I understand that and it is probably the same for the Department of Health, but it is important that that data, because of policy differences, is available.
Mrs Hart: Yes, it is important that people have clarity and understanding of the differences in the systems and the impact that has, I totally concur.
Q253 Chairman: Minister, can ask the last
question and it concerns the Muscular Dystrophy Campaign. Last September that campaign published a very
important and very comprehensive report.
Could you give us an outline of how you have responded to that
report? Essentially, the report calls
for a much more integrated approach across the
Mrs Hart: Can I say it fitted very nicely actually into the neuroscience implementation reports which we discussed earlier, and I have referred all those reports to the Local Health Boards for implementation and that should help, I think, to improve services within this particular area of muscular dystrophy in the long-term. I think it is fair to say, and I am absolutely prepared to acknowledge, that there were not the clear care pathways that there should have been in this particular area, and we will be resolving these matters.
Q254 Chairman: I think we have asked all
the questions. Could I say how pleased
we are not only that you have come here but we have had three Welsh Ministers
here today. It has been a remarkable
day. We have had five Ministers in
total. Could I say the great importance
we attach to your statement about not only asserting but celebrating the fact
that we have one National Health Service and that we can learn from one
another. Within that context I am
particularly delighted that you endorsed our thoughts in relation to the
veterans and we look forward to progress on behalf the veterans in
Mrs Hart: I would be delighted to extend an invitation to the Welsh Affairs
Select Committee to have a briefing particularly on the specifics of veterans'
issues within
Chairman: I am
sure I can speak on behalf of the Committee and say we would be very pleased to
have that briefing. We look forward to
you coming again before us. Maybe next
time it will be in