Cross-border Healthcare

Debate between Ann Davies and Llinos Medi

Tuesday 4th November 2025 Westminster Hall

[Llinos Medi (Ynys Môn) (PC)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I, too, congratulate the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick) on securing this important debate.

In January, the Welsh mental health charity Llais reported to the Welsh Affairs Committee that

“15-20% of people living in Wales use NHS services in England. In the border counties, this percentage is far higher and can be nearer 50%.”

Existing provisions aim to ensure that no patient’s treatment is denied or delayed due to differing rules or funding responsibilities across health systems on either side of the Wales-England border. None the less, the British Medical Association reports significant issues in how these provisions are offered. These systems can be complicated for patients, who are not always clear about who is responsible when their care and treatment cross the border. People living in Wales continue to face a range of challenges if they need care and treatment in England. Llais’s evidence referred to issues around announcements made by the UK media covering England-only stories. It is not clear whether the announcements apply for the people who live in Wales.

[Ann Davies (Caerfyrddin) (PC)]

My constituent Michael Riordan has asked his GP to refer him to a facility available to armed forces veterans located in Shropshire but, due to an issue with cross-border funding, the Welsh NHS will not fund that facility, despite his residence not being an issue when he volunteered for service to his country. This excellent facility is now unavailable to Michael. Does my hon. Friend agree that current issues in cross-border funding must be addressed for the sake of our constituents?

[Llinos Medi]

That is another example of what we have already heard, where cross-border work is not working for a timely patient outcome. I agree with my hon. Friend.

Ensuring that cross-border health is as seamless as possible means developing strong partnership, introducing effective ways of sharing information and learning, communicating well, and making advice and information easily available and accessible. Solving these issues needs co-operation between Governments on both sides of the border.

It is just over a year since Eluned Morgan, the First Minister of Wales, announced a cross-border health plan. The Secretary of State for Wales, the right hon. Member for Cardiff East (Jo Stevens), vowed to deliver “additional surgical procedures”. When asked to provide an update on that programme in the Senedd last month, and on how many more patients in Wales have been treated in England over the past 12 months, the First Minister’s answer was vague and non-committal. It is obvious that the bureaucratic problem in making cross-border referrals, as evidenced by the British Medical Association and by Powys health board, which has asked to reduce the number of patients sent for treatment due to financial constraints, is completely at odds with the promise made by the First Minister and the Secretary of State. It seems increasingly clear that this announcement has not led to the changes that we all, and our constituents, would like to see on our waiting lists. Those remain stubbornly high in Wales, with figures showing 794,500 to 796,000 patient pathways as of mid-2025.

We are all aware of the huge pressures being placed on the NHS in Wales by social care. In April, the Welsh Local Government Association warned that plans to reduce NHS waiting lists in Wales will fall short unless we see targeted investment in social care. This week, my Plaid Cymru colleagues in the Senedd will follow that advice by calling for the establishment of a national care service for Wales. That would be a serious step in the right direction.

The people of Wales deserve better than poorly planned announcements leading nowhere. I encourage the Minister to impress upon her Welsh Government colleagues to throw their support behind our plan to get to grips with the high waiting list blighting our health service. Diolch.

Agricultural Property Relief

Debate between Ann Davies and Llinos Medi

Tuesday 28th January 2025 Westminster Hall

[Ann Davies]

I totally agree. Nobody understands those fields better than the farmer who has worked that land. They know where those wet corners are and they know where they should not tread during certain times. The sustainable farming scheme—the SFS—is coming out in Wales next year, and it is about nature restoration, so I absolutely agree.

Estate agents in west Wales are already seeing increased investor interest in purchasing farms following the autumn Budget. Selling land to pay an inheritance tax bill will inevitably hit tenant farmers because the £1 million threshold will hit asset-rich estates. Around 30% of land in Wales is farmed under some sort of tenancy agreement and, although some is local authority-owned, much is owned by private landlords. The Tenant Farmers Association anticipates that more insecure agricultural tenancies will be terminated to allow land to be sold to avoid taxes on death. Other landlords are reducing the lengths of term offered to tenants, who were expecting longer leases, so that farms are more readily sellable in case of tax change.

[Llinos Medi (Ynys Môn) (PC)]

Tenant farmers on Ynys Môn are expected to be impacted by the change to APR because landowners there will have no option but to sell their farms to cover the additional cost. The landowners have a good relationship with their tenants but they have no choice but to sell, leaving generational farmers to lose their homes, businesses and future, with long-lasting effects on the rural community. Does my hon. Friend agree that the realities of agriculture in Wales, including for tenant farmers, must be fully considered by the UK Government in a Wales-specific impact assessment?

[Ann Davies]

Diolch yn fawr. I absolutely agree with my hon. Friend. I should add that the wider economy will lose another vital source of food production. If that land is taken, it will never go back into food production.

My hon. Friend mentioned the effect on Wales, and there is a knock-on effect on the Welsh language: 43% of those involved in agriculture in Wales speak Welsh. Keeping our farming communities alive is key to moving towards the Welsh Labour Government’s target of achieving 1 million Welsh speakers in 2050. There is real worry—farming constituents have told me, with an eye on what it means for their own children, that they are concerned about the impact of the changes on future food production by Welsh-speaking families in areas of Wales already facing depopulation.

The families behind farming businesses are important to this debate. They are not just figures; they are people—people such as Richard Twose of Maenhir, who runs a 700-acre farm of 400 Holstein dairy cows and 300 pedigree Lleyn ewes with his parents, brother and children. APR and BPR changes have blown apart the family’s succession plans. They may now be forced to transfer the parents’ share in the farm and hope that they live for another seven years, or else the family will face a big tax burden on top of their business debt. Just yesterday I heard that, to add to the family’s worries and concerns, Richard’s father had passed away suddenly over Christmas.

The APR and BPR changes do not appear proportionate, in many ways. Inflation has already eroded the nil rate tax band of £325,000, which has been frozen since 2009 and is set to remain frozen until 2030. When APR and BPR were introduced, the nil rate band covered 56 acres of farmland; today, it covers 29 acres.

How the changes apply is not fair because the particularities—who someone shares the farm with, which tools or machinery they own or have hired, how much business debt they have—have a direct impact on their inheritance tax bill. Although the Government have said that married couples and their descendants can benefit from up to £3 million in tax relief, in reality tax experts are quoting figures that vary between £2 million and £4 million, based on different scenarios. We must remember that the Chancellor stated in October that the starting point for calculations is £1 million.