When you have a country where 50 per cent of the population live within 25 miles of the English border, the matter of cross-border healthcare is an essential one. We can’t draw a neat line and insist that the population living on the border must trot off to be seen just by the Welsh NHS staff. It’s unrealistic, it’s impractical, but most of all, it simply wouldn’t suit many members of the public who live on the border. So, having a constructive and healthy relationship between health boards on both sides of Offa’s Dyke is imperative, and this week’s publication of the report on the sustainability and transformation plans for Shropshire and Herefordshire are critical to healthcare delivery in Powys—an area that I, like the Member opposite, represent.

Now, whilst we in Wales recognise the importance of cross-border working, I think it’s worth noting that, in the guidance to English trusts, the Tory Westminster Government made no reference to cross-border working arrangements nor the care that should be provided to Welsh patients. I therefore welcome the fact that this omission is recognised by the Shropshire, Telford and Wrekin partnership board and that there is a specific reference by the English health boards that their hospitals are the main providers of acute care for communities in Powys and that they understand that within those transformation plans.

But let’s be clear, whilst it’s true that Wales needs our border patients to be treated in Shropshire and Herefordshire, their services would not be sustainable without Welsh patients—without the money given to them by the Powys teaching health board. For many people living in Powys, the majority of their hospital care is provided in England.

The recently published strategic commissioning framework sets out how the Powys teaching health board works with providers in Wales and England to deliver the standards of quality and access that they expect on behalf of Welsh patients in line with Welsh and UK arrangements for cross-border healthcare. It also helps to deliver the recommendations set out in the Welsh Affairs Committee report on cross-border health arrangements.

Now, I’ve met with health campaigners in Powys who have real concerns, in particular about access to primary care. GP recruitment is not just a problem on the border; it’s a problem that we encounter across most of Wales and I do hope that the Government recruitment drive on this issue will go some way to resolving this problem. I think it’s worth underlining that for patients and providers in Powys, the added difficulties of working across two governments, differing structures and political direction, does mean that there is an issue in terms of accountability. But I don’t think it’s impossible for health providers, even at primary level, to come together to do what’s right for patients and to provide a seamless service. There’s an example of this where GPs on the Powys-Shropshire border are working closely together for the communities in Knighton and in Clun. Now, the two current practices have worked alongside the health board to overcome the challenges of rural healthcare across that border and they therefore are meeting the expectations of the Welsh Labour Government’s programme for government.

This morning, the Future Fit programme board met and recommended a set of preferred options for the delivery of healthcare that will impact patients in Powys and in particular patients in Montgomery. These recommendations end years of uncertainty about where services should be delivered. So, whilst I welcome the return of a consultant-led women and children’s centre to the Royal Shrewsbury Hospital, I’m keen to explore further the impact of moving the majority of day-case surgery to Telford. I’ll be meeting with Powys teaching health board in the new year, seeking to establish if more day-care surgery can take place this side of the border, reducing travel time for Welsh patients. In many ways, the border between England and Wales might seem bigger than ever, but in terms of healthcare, as we’ve seen just today, through collaboration, positive engagement and respect for the NHS on both sides, progress can be made to resolve those problems that are felt on both sides of the border.