Cross-border Healthcare

Steve Witherden Excerpts

Tuesday 4th November 2025 Westminster Hall

[Steve Witherden (Montgomeryshire and Glyndŵr) (Lab)]

It is a pleasure to serve under your chairship, Mr Dowd. I thank the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick), with whom I share a health board, for securing this important debate.

Montgomeryshire and Glyndŵr is served by two of the three Welsh local health boards that directly border England—65% by Powys teaching health board in mid-Wales and 35% by Betsi Cadwaladr university health board in the north. Powys is unique: it is the largest county in Wales by area, yet it has no full-service hospital. As a result, many of my constituents in the Montgomeryshire area rely on hospitals in England for their secondary and specialist care.

Recently, Powys teaching health board asked NHS England to delay care for Welsh residents in order to meet its savings targets. English hospitals have pushed back, arguing that such measures increase clinical risk and undermine the trust on which the system depends. We cannot allow a two-tier system to develop, whereby Welsh patients become second-class citizens. Patient data is delayed or simply fails to cross the border, leading to unnecessary delays and confusion. To reduce cost or manage a scarce resource, services are centralised in one location, causing either significantly more travel in an already huge geographical area with poor public transport, or significant delays in an emergency, with ambulances commissioned to serve Wales being diverted to calls in Staffordshire.

Let me give two examples from my constituency that demonstrate how the system can fail those it is supposed to serve. First, one resident from Powys was for many years referred to the dermatology clinic in Shrewsbury. Following a reorganisation by the local integrated care board, diagnostic services were moved to Telford while treatment remained in Shrewsbury. The result was a 120-mile round trip for a single course of care. That is a heavy burden for any patient, especially those managing long-term conditions.

Secondly, a woman living close to the border, who was registered with a Shropshire GP, was diagnosed in September with breast cancer. She was told she would need to wait to be seen by the north Wales genetics clinic. Because of delays, she was advised to begin chemotherapy before surgery—a course that carries more side effects and lengthens recovery. A private consultant later questioned whether the chemotherapy had even been necessary. In the end she felt forced to pay privately, to receive timely treatment. That is simply unacceptable in a publicly funded health service.

We all know that we need effective care as close to home as possible, and a crucial part of co-operation must be data sharing. The solution is openness, communication and shared standards. I meet regularly with the NHS trusts and integrated care board that provide health care for my constituents. I have been impressed by their openness and frankness, and their desire to tackle the issues they face with practical enthusiasm. I am currently organising a meeting to understand the issues from their point of view and address cross-border issues.

I know that both Powys teaching health board and the English trusts ultimately want the same thing: to provide the best possible care for those who need it. I want patients to receive the best possible care as close to home as possible. I want clinicians to have the information, resources and support they need to treat people swiftly and safely. Finally, after years of austerity and underfunding, it is vital that we keep PFI and private interests out of our NHS. We must defend it as a truly public service, just as Nye Bevan, our great Welsh hero, intended.