The Issues

The Issues


In the border areas between England & Wales there are GPs who are registered in Wales (paid by Wales) and GPs who are registered in England (paid by England). These GPs have patients who live in England and patients who live in Wales because their GP practice crosses the geographical boundary between England and Wales.

Before 1 April 2012: these GPs could refer patients to the consultant and hospital in England or Wales who would provide the best treatment in the shortest timescales and it didn’t matter whether the patient lived in Wales or England. The Department of Health and the Welsh Assembly government worked out between them how much they needed to pay each other to cover this type of treatment (known as secondary care) and the patients were unaware of the arrangements.


After 1 April 2012 the rules changed. A new set of rules came into effect. The Department of Health still gave the money to the Welsh Government to provide treatment in hospitals and consultants for patients resident in Gloucestershire but delegated the purchase of this healthcare to the Aneurin Bevan Health Board (ABHB) for this group of patients. The ABHB decided to use the money to purchase this healthcare primarily in Wales to benefit their health service (with some exceptions) and took away the English residents patients’ choice on the grounds that there is no choice allowed in Wales and their GP is registered in Wales. In Wales, patients have a voice but English resident patients don’t have a voice as they cannot vote in Wales so they get the worst of all worlds.

No choice ; No voice


Case Studies


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