2. Will the First Minister make a statement on cross-border health arrangements between England and Wales? OAQ(5)0548(FM)

A cross-border protocol is in place to ensure relevant patients have access to appropriate services, and all associated matters are handled in an agreed and consistent manner.

First Minister, you will be aware of the ongoing Future Fit process on the future of emergency healthcare services for patients in Shropshire and mid Wales. It’s important for my constituents that emergency services are based in Shrewsbury. To date, the Welsh Government hasn’t taken a public position in this regard. Can I ask what prevents you from taking a view on this matter and making strong representations to the NHS Future Fit programme board on behalf of mid Wales’s residents? Will you take a position?

Geographically, Shrewsbury is closer, and so we would prefer services to be based in Shrewsbury. But it’s important to ensure that services are safe and sustainable, which is something, of course, that we’ve had to deal with ourselves. I know, for example, with ophthalmology and neurology, that the health board—Powys, that is—has secured alternative provision for ophthalmology services through an organisation called The Practice, which does include community outreach clinics within Powys. But clearly, from our perspective, we would wish to see services that are accessed by Welsh people in England as close to those Welsh patients as possible.

First Minister, today we learn that there has been a 16 per cent increase in the number of junior doctors choosing to come to or stay in Wales to train to become GPs. Across the Welsh NHS, waiting times are going down; average response times to emergency calls are now less than five minutes; the British Heart Foundation described Wales as a world leader in cardiac rehabilitation; there’s improvement in cancer performance, with the number of patients treated now 40 per cent higher than five years ago; and for the fourth successive month we are getting people home from hospital faster. First Minister, in England the proportion of patients being treated or discharged in time fell below 78 per cent, with nearly half of hospitals declaring—

You do need to come to a question.

[Continues.]—major alerts because of a shortage of beds. What message do you have for the men and women who work in the national health service and have had to endure the Tories’ attempts to denigrate the Welsh NHS over the last few years?

Well, we all saw what the Tories did in 2015, but the Member makes a robust and comprehensive case that shows the progress that the Welsh NHS has made. Today we see that more GP training places are being filled and it shows that the Welsh NHS is seen as a good place to work, and that good progress will continue in the future.

At the same time as fulfilling a genuine need, cross-border healthcare co-operation can also serve to mask the shortage of specialist clinical staff in Wales, which has been caused by the failure of Government to train sufficient clinicians. When are you going to review the number of self-standing organisations within the Welsh NHS, which receive tens of millions a year, with a view to reducing them so you can spend more on specialist clinicians for Wales itself?

If we look at a rural authority like Powys, it’s inevitable that an authority like Powys will access specialist services from England. Geographically, it makes sense for people who live in large areas of Powys. In fact, there are specialist services in England that rely on Powys patients in order to be sustainable. Accident and emergency in Hereford is an example of that; without patients coming from eastern Breconshire particularly, the numbers going through Hereford’s A&E would cause questions to be asked about the sustainability of the service in Hereford. So, no; from my perspective, the last thing I want to see is any kind of wall come down between Wales and England in terms of healthcare. We know as well that 25,000 people cross the border the other way, to get A&E services in Wales. That’s why, of course, we have a robust protocol in place to ensure that services are available to people on both sides of the border.