David Chadwick

My hon. Friend is right to say that these system failures are putting extra responsibility, extra stress and often extra cost on individuals, which is why the system needs to be improved. Beyond the funding and IT problems, our systemic weaknesses make cross-border care even harder. Many Powys residents are registered with GPs in England simply because of geography—they might be closer—while others just across the border stay with Welsh practices. GPs who want to work in both nations must register twice, fill out the same forms twice and follow two sets of rules, which wastes time and discourages flexibility. A constituent of mine in mid-Wales with a rare artery condition needed ongoing treatment from Hereford hospital. Because the two NHS systems do not share results, they had to collect their own blood tests and email them to their consultant each month. Prescriptions issued in England were not approved in Wales, causing months of delay. That is the daily reality of an unco-ordinated system. At the governance level, the 2018 cross-border statement of values and principles remains voluntary and unenforceable. Each Welsh health board negotiates its own arrangements with English trusts. There is no single tariff, no unified billing system and no consistent data reporting. Audit Wales has warned for years that this patchwork leaves patients in limbo, between two systems that both claim to care for them, but neither fully owns responsibility when things go wrong. Those problems did not appear by accident. Powys residents do not mind which NHS logo is printed on their appointment letter; they care that their care arrives on time, that their doctors can speak to one another, and that they are treated fairly. The border should not be a barrier to treatment, data or fairness. I say to the Minister that although several of these issues fall within devolved areas, they are of direct concern to the UK Government because they are also directly influenced by NHS England and by decisions taken here in Westminster. My asks are simple. First, convene a meeting with counterparts in the devolved nations to finally address these cross-border challenges, and invite border MPs to that discussion. Those of us who represent border communities see these failures at first hand and know where the solutions are needed. Secondly, provide the funding required to make NHS IT systems interoperable across the United Kingdom, so that clinicians can share patient information safely and instantly wherever care is delivered. Thirdly, work with devolved Governments to give the cross-border statement of values and principles legal force, turning it from a voluntary pledge into a real, accountable framework that protects people in border communities like Powys. We owe it to the people of Powys, and to every border community, to end this quiet injustice and to build a system that treats them not as second-class citizens but as equals who are entitled to the same care, dignity and chance to live free from pain. Labour Governments at both ends of the M4 talk about driving down waiting lists and getting people back into work. However, this policy, which Ministers could stop tomorrow, does the exact opposite. I look forward to the Minister’s response and the contributions from other Members.