Annex A > Chapter 11 - Referrals > Referrals to Bristol from South Wales > Funding of referrals from Wales
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Funding of referrals from Wales
144 Mrs Maclean of the Inquiry Panel asked Mr Angilley about the financing of Welsh referrals to Bristol:
`Q. ... To go back to the finance implications, when you were describing clearing the top-slicing procedure with the regions, could you just tell me how that worked out in Wales? Were there different procedures, given that this is an England and Wales thing?
`A. I do not think that the money, from recollection - I would need to look at that and come back to you, if I may.' [151]
145 Subsequently, Mr Angilley wrote to the Inquiry in answer to Mrs Maclean's question:
`Towards the end of my oral evidence to the Inquiry, Mrs Maclean asked a question which I was unable to answer. Her question concerned the procedure by which the Supra Regional Services Advisory Group's recommendations for top-sliced funding were cleared with Welsh interests. The answer is that the cost of these services were met entirely by the NHS in England, so it was not necessary to clear the funding proposals with the Welsh. I believe that at the inception of the Supra Regional Services, the Department of Health agreed with the Welsh Office that in view of the relatively small number of patients and the bureaucracy involved, it was not worth charging the Welsh NHS for its use of these services. However, the Welsh Office had a standing invitation to send an observer to meetings of the Advisory Group, which they normally did during my time as Secretary. Although their representative was not a voting member, he or she would be free to advise the Group on any issue affecting Wales.' [152]
146 Mr Steven Owen, Administrative Secretary to the SRSAG from January 1992 to February 1996, was asked in oral evidence whether or not the SRSAG took into account the existence (or non-existence) of facilities on the other side of domestic borders when deciding which centres to designate, and if so what were the cross-border funding arrangements. He said:
`Because of the funding quirk - and I understand Mr Angilley has undertaken to provide a paper on this - essentially there was an understanding and agreement that patients from Wales could be treated in English units without any cross-funding matters being undertaken. That also operated for Scotland, but that is almost by the by. Scotland and Wales were entirely free to provide whatever healthcare facilities they chose for their own patients in whatever infrastructure and formation they decided was best for their patients.' [153]
147 Mrs Maclean questioned Mr Owen further. His evidence included this exchange:
`Q. ... Perhaps I might take the opportunity to pursue my enquiries about the impact of the SRS funding mechanism for Wales. I know that Mr Angilley is dealing with this and you may prefer to leave it to him, but to deal with my impatience, can you enlighten me as to the impact of SRS funding for the Welsh Office?
`A. There was no impact at all. SRS funding was for the English units, but because of a quirk in the financing system, which will be the subject of a paper Mr Angilley is providing, it was allowed that Welsh residents could be treated in English units without a bill, if you like, going back to the patient's district of residence in Wales.
`Q. So this was a "freebie", in effect?
`A. In effect, yes, that is right.' [154]
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Footnotes
[152] WIT 0034 0005; letter from Mr Angilley to the Inquiry dated 6 May 1999