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Cross-Border Provision of Public Services for Wales: Follow–Up

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Cross-Border Provision of Public Services for Wales: Follow–Up House of Commons Welsh Affairs Committee Cross-border provision of public services for Wales: follow–up Tenth Report of Session 2009–10 Report, together with formal minutes, oral and written evidence Ordered by the House of Commons to be printed 2 March 2010 HC 26 Published on 11 March 2010 by authority of the House of Commons London: The Stationery Office Limited £0.00 The Welsh Affairs Committee The Welsh Affairs Committee is appointed by the House of Commons to examine the expenditure, administration, and policy of the Office of the Secretary of State for Wales (including relations with the National Assembly for Wales). Current membership Dr Hywel Francis MP (Labour, Aberavon) (Chairman) Mr David T.C. Davies MP (Conservative, Monmouth) Ms Nia Griffith MP (Labour, Llanelli) Mrs Siân C. James MP (Labour, Swansea East) Mr David Jones MP (Conservative, Clwyd West) Mr Martyn Jones MP (Labour, Clwyd South) Rt Hon Alun Michael MP (Labour and Co-operative, Cardiff South and Penarth) Mr Albert Owen MP (Labour, Ynys Môn) Mr Mark Pritchard MP (Conservative, The Wrekin) Mr Mark Williams MP (Liberal Democrat, Ceredigion) Mr Hywel Williams MP (Plaid Cymru, Caernarfon) Powers The committee is one of the Departmental select committees, the powers of which are set out in House of Commons Standing Orders, principally in SO No 152. These are available on the Internet via www.parliament.uk. Publications The reports and evidence of the Committee are published by The Stationery Office by Order of the House. All publications of the Committee (including press notices) are on the internet at www.parliament.uk/parliamentary_committees/welsh_affairs_committee.cfm. Committee staff The current staff of the Committee is Dr Sue Griffiths (Clerk), Alison Groves (Second Clerk), Anwen Rees (Inquiry Manager), Christine Randall (Senior Committee Assistant), Annabel Goddard (Committee Assistant), Tes Stranger (Committee Support Assistant) and Rebecca Jones (Media Officer). Contacts All correspondence should be addressed to the Clerk of the Welsh Affairs Committee, House of Commons, 7 Millbank, London SW1P 3JA. The telephone number for general enquiries is 020 7219 6189 and the Committee’s email address is [email protected]. Cross-border provision of public services for Wales: follow–up 1 Contents Report Page Summary 3 Further and Higher Education 3 Health 4 Transport 4 1 Introduction 6 Our inquiry 6 2 Further and Higher Education 7 Background 7 Further education 7 Cross-border arrangements 8 Sector Skills Councils 9 Higher education 11 Co-ordination of higher education policy 13 Higher education funding 14 Research funding 16 Cross-border collaboration 19 Conclusion 20 3 Health 21 Background 21 Border-proofing of policy and practice 21 Revised protocol for cross-border healthcare commissioning 22 Co-ordination between the Department of Health and the Welsh Assembly Government 24 Clinical excellence as close to home as possible 27 North Wales and North West England 27 Reorganisation of the NHS in Wales 29 Specialist care for rare conditions 31 Cross-border citizen engagement 33 Raising awareness 33 Accountability of Foundation Trusts 34 Transparent and accountable co-operation between localities, regions and governments 35 Learning from devolution 35 Conclusion 37 4 Transport 37 Background 37 Rail 37 Electrification 38 Swindon-Kemble line 42 High Speed Rail 44 2 Cross-border provision of public services for Wales: follow–up Rail passenger forecasts 45 Severn Tidal 45 Road 46 Road Improvement works 46 Severn Bridge tolls 48 Traffic Commissioner 49 Air 50 Ports in Wales 51 Conclusion 52 5 Conclusion 53 Conclusions and recommendations 54 Health 56 Transport 58 Formal Minutes 61 Witnesses 62 List of written evidence 63 List of Reports from the Committee during the current Parliament 65 Cross-border provision of public services for Wales: follow–up 3 Summary This Report follows up a detailed inquiry into cross-border services in which we examined further and higher education, health and transport provision across the Welsh-English border. Policy divergence is a natural and intended consequence of devolution. Our original inquiry produced evidence that policy makers in Cardiff and London were failing to consider the impact of policy differences on people on either side of what is a long and porous border. As a consequence, some of those needing to cross the border for access to public services were receiving a poorer quality of service. This follow-up inquiry has shown that many of the specific difficulties we identified have been resolved. Communications and consultation between the Welsh Assembly Government and the relevant UK Government departments appear to be much improved in these cases, although policy co-ordination in general remains variable. We believe that there is a need for a clear framework for routinely assessing and comparing the impact of new policies in each of the the four nations. There is a particular need for clarity about territorial extent in major policy documents. Too often, England-only policies are presented under a UK banner and the way in which they will interface with devolved responsibilities is not made explicit, and the converse is sometimes the case. The cross-border liaison structures established in response to the difficulties we identified in our earlier Reports need to be sustained in order to have an enduring effect. Engagement at the local level is also vital. Since our earlier inquiry, there has been good progress in some areas of co-ordination and we note in particular the positive contribution that can be made by those Regional Ministers who are actively engaged in developing a strategic approach to service provision in their region. They are well placed to encourage a strategic approach to cross-border issues and to develop strong working relationships with Welsh Assembly Ministers and their officials. There remain, however, a number of outstanding issues in the specific areas we examined where progress has not been made. Further and Higher Education Higher education is in a period of change both in Wales and England. Welsh higher education institutions already receive a lower level of funding from the Assembly Government than those in England and the Department for Business, Innovation and Skills has a responsibility to ensure that Wales does not lose out even more from the changed focus of research priorities. We are not convinced that the Department properly considered devolution issues when developing this strategy. The amount of consultation and communication between the Welsh Assembly Government and the Department for Business, Innovation and Skills has clearly increased. We welcome the fact that the Minister is open to discussing the co-ordination of higher education policy at a Joint Ministerial Committee meeting and suggest that now is the time to do this, given the recent publication of the Welsh and the English higher education strategies. We welcome the publication of revised guidance covering arrangements for cross-border further education. The Welsh Assembly Government has also assured us that it is fully involved in the Sector Skills Council relicensing process. It is vital for new structures to 4 Cross-border provision of public services for Wales: follow–up enable the Sector Skills Councils to give due regard to territorial differences in skills policies and in the configurations and weightings of different sectors. Health A revised cross-border health protocol and accompanying financial transfer from England to Wales has resolved most of the outstanding disputes with regard to the commissioning and funding of hospital care in England for patients resident in Wales. Monitoring of the protocol’s implementation will be a key issue as policy continues to develop and change on both sides of the border. This should be carried out in a way that is transparent to providers and patients. More needs to be done to raise public awareness of the differences in services they can expect to receive in England and Wales, as recommended in our earlier Report. The improvements in co-ordination at governmental level should be matched by transparency for patients and citizens. Foundation Trusts should be bound by the same dispute resolution procedure as other providers. The replacement arrangements for Health Commission Wales must ensure a consistent, equitable, responsive and timely approach to the provision of cross-border specialist health services. The removal of one national body for specialist commissioning must not result in confusion of responsibility and unacceptable local variation of policy and practice. One way to achieve this may be through the adoption of common commissioning structures for rare conditions with England and we look forward to the outcome of current discussions on this subject. There is a serious and persistent lack of comparative data on which to build any solid research comparing the performance of the NHS in the devolved nations. Ministers expressed little enthusiasm to tackle this situation, and we consider this to be a serious mistake given the acknowledged benefits of learning from different practice in each of the home nations of the UK. Transport We warmly welcome the decision to electrify the Great Western Main Line, as recommended in our earlier Report. The planned use of bi-modal electric/diesel trains should reduce disruption for passengers, and we were reassured to hear that electrification work will take place as a rolling programme along the whole length of the line, allaying concerns expressed in earlier evidence that electrification might extend only between Bristol and London. A solution has not yet been found to electrify the Wrexham-Bidston line, but we urge all parties to continue to work towards improvements, with electrification as the ultimate aim. A substantial amount of money has now been promised to redouble the Swindon-Kemble line. This line is an important diversionary route between South Wales and London when the Severn Tunnel is closed. Its importance will be heightened during electrification work on the Great Western Main Line.
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