Clause 1 - NHS foundation trusts
Health and Social Care (Community Health and Standards) Bill
10:30 am
Mr Chris Grayling (Epsom and Ewell, Conservative)
This is a concern of mine. We had extensive debates about border issues during the
passage of the Health (Wales) Act 2003, including the implications for those on both sides of the border. I commend my right hon. Friend the Member for North-West Hampshire for successfully tabling the amendment. He was more successful than me in finding words that would allow the Bill to be amended. I share his anxieties, and those of the hon. Member for Cardiff, Central (Mr. Jones), about the implications of the wording of the clause, which contains no cross-border provision.
We are still a United Kingdom. As the hon. Member for Cardiff, Central said, in areas close to a border, people depend on acute services across that border. The Bill contains no obligation to provide those services. There are certainly areas in which specific health priorities cannot be addressed as a result of the Bill's measures. There is no duty. As my right hon. Friend said, it is not simply a question of a duty to provide, but a duty to plan. Under the terms of the clause, a foundation trust that wishes to invest in and expand its services, based on its catchment area, cannot, strictly speaking, take into account the population on the other side of the boundary.
Let me go one step further than the hon. Member for Cardiff, Central, and give a specific example of an anomaly that may arise. Ministers will know of the Countess of Chester hospital trust, one of those that have applied, or sought to apply, for foundation status. Ministers will also know that the geography of Chester is such that almost immediately one leaves the city, heading west, one is in Wales. A significant part of the catchment area of that trust is in Wales. Indeed, most of the hospital's patients come from Chester, Ellesmere Port, rural west Cheshire and the Deeside part of Flintshire. The trust provides just over 600 acute hospital beds, which serve that area. The trust describes itself as one of the leading providers of acute services in the area. A substantial number of people depend on the hospital for their health care.