Border MP highlights gaps health service provision

April 22, 2009 at 8:05 am Leave a comment

by Andrew Brentnall

Mark Harper MP (Con, Forest of Dean) argued in Parliament yesterday that the devolution of the health service has decreased the quality of provision for those living near an internal border in the UK.

At present, people who live in England but have a GP registered in another country must use the services of that separate health service – in Harper’s case his constituents must use the Welsh NHS.

Harper argued that this forces people to use health services over which they have no democratic control, and the major differences and lack of coordination between the two means that some constituents are at a disadvantage.

“If someone lives in England, they can vote on and influence only English health service policies,” said Mr Harper.

“However, a number of them are forced – because they have no ability to use a GP registered in England – to use, and are dependent on, services provided by the Welsh Assembly Government.”

Mr Harper highlighted a significant flaw in regards to cancer screening.

He explained that “in England, screening for bowel cancer is carried out according to someone’s GP registration, but in Wales, it is done by residence.

“So if someone is one of the 8,000 people who live in Gloucestershire but have a GP registered in Wales, they do not get screened in England and they do not get screened in Wales.”

The current system is the result of an interim protocol put in place in 2005 due to problems of accountability between the two services.

Health Minister, Ben Bradshaw explained, “The protocol agreed that the responsibility for a patient would be determined by GP registration rather than by residence. Therefore, if a person’s GP was in Wales, they would be the operational responsibility of the NHS in Wales, even if they lived in England, and vice versa.”

The Welsh Assembly has confirmed this ‘protocol’ will be in place until 2011, something which the Commons Welsh affairs select committee says it is ‘disappointed’ and ‘disturbed’ about in a recent report into the matter.

Mr Bradshaw argued that the border between England and Wales had “never been a barrier to health care”, and explained that devolution was introduced to “push power closer to the people of Britain.”

He recognised that this situation created tensions for healthcare providers and commissioners but drew attention to the ‘vital importance’ of a patient’s right to choose their GP so that they receive “high-quality care”.

“One of the things that we are introducing in England, as opposed to Wales of course, is much greater choice for people in registering with GPs, and we are reforming the GP contract to deliver that greater choice for the public.”

The minister agreed to look into Mr Harper’s concerns around screening, and said he would “discuss it with [Harper’s] PCT to see if there is any alternative solution that would satisfy both the principles of the protocol and the desire of some of his constituents to be registered with a GP in England.”

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