How England helps the Welsh NHS

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By Nick Triggle Health reporter, BBC News Waiting times are approaching 18 weeks in EnglandWith no charges for prescriptions and the prospect of free hospital parking, the Welsh NHS is often compared favourably to England.

But for a string of hospitals running from Bristol to Liverpool the post devolution health service can seem very different.

They are responsible for treating thousands of Welsh patients who hop across the border each year to make use of the non-emergency treatment available.

The figure topped 28,000 last year - a 12% jump in two years - and nearly 10 times the figure for Scottish patients.

With its short waiting lists and extensive range of specialist services, English NHS trusts are an obvious attraction.

Waiting

While England is closing in on an 18-week target, Welsh patients can still find themselves waiting for anything up to 44 weeks.

The goal is to reduce this to 26 weeks by the end of 2009, but the drive to get times down has caused problems.

Many Welsh health boards have been forced to pay for their patients to be treated in English hospitals after struggling to hit targets.

And while there are signs that Wales is getting to grips with the issue, that cannot mask the fact that there is still a heavy reliance on English trusts while movement the other way is much more limited.

There is no evidence that English patients are being disadvantaged Welsh Assembly Government spokesman

Hospital trusts such as Herefordshire, Shrewsbury and Telford and North Bristol all get significant numbers of patients from Wales.

But a Welsh Assembly Government spokesman was quick to point out: "There is no evidence that English patients are being disadvantaged."

He said that on the whole they were treated according to the Welsh waiting times rather than quicker English ones, while the Welsh NHS pays for their care.

David James, director of operations at Robert Jones and Agnes Hospital, a specialist orthopaedic centre in Shropshire which gets between 30% to 40% of its patients from Wales, said: "It is partly geographic in that we are the nearest hospital and partly because of our reputation.

"Patients know they get high quality and quick care so we do get a lot of patients. It does not interfere with our ability to treat English patients and if it did we would change things."

Nonetheless, the trend has still upset some.

Free prescriptions

Joyce Robins, of Patient Concern, said: "Wales has decided to invest in things such as free prescriptions and car parking so patients can benefit.

"But in England, patients do not get that, but the pay off is that we have much better waiting times.

"I think many would find it unfair that English hospitals are being used in this way."

But Michael Sobanja, chief executive of the NHS Alliance, said English patients should not be too worried.

"I suppose these things were inevitable following devolution, but it can certainly seem peculiar to patients with some having to wait longer than others and some paying for prescriptions when other don't.

"What I think it does demonstrate is that it is not all one-way traffic. The English NHS does have some advantages."