The Welsh Liberal Democrats have called on the new Health Minister to “look again at the detail” of cross-border healthcare arrangements affecting patients in Powys, warning that some people are now waiting up to two years for treatment.

Brecon, Radnor and Cwm Tawe MP David Chadwick has written to Plaid Cymru Health Minister Mabon ap Gwynfor about delays faced by patients who are referred for treatment in English hospitals in Herefordshire and Shropshire.

He says changes to commissioning arrangements mean Powys Teaching Health Board is no longer paying for treatment at the faster rates previously available across the border, despite Powys having no general hospital of its own.

As a result, patients are now waiting significantly longer for appointments and operations, in some cases up to an extra year or more.

In his letter, Mr Chadwick said some constituents were “effectively being treated as second-class citizens” compared with patients in England, despite using the same hospitals.

He also argued the situation is being driven by funding pressures within Powys Teaching Health Board and called for urgent action from the Welsh Government.

Mr Chadwick wrote: “It cannot be right that Powys residents are forced to wait longer for treatment simply because they live in Wales, despite accessing the same hospitals and services as patients living just across the border.”

He added that cross-border arrangements with hospitals in Herefordshire and Shropshire had “served patients well” and were in place because Mid Wales does not have a district general hospital.

However, in response, Health Minister Mabon ap Gwynfor said it is the responsibility of health boards to plan and deliver services and meet national performance targets.

“I expect all patients to be treated in order of their clinical priority, no matter where they are treated, whether that is in England or Wales. However, all Welsh residents who are treated in English hospitals are subject to Welsh waiting time standards,” he wrote.

The Minister also said the Welsh Government has committed to commissioning an independent review of NHS performance and plans to develop up to 10 new elective hubs to increase capacity.

“It is the responsibility of health boards to plan and deliver services to meet the needs of their local populations and achieve national performance targets,” he wrote.

But the Liberal Democrats say the response fails to reflect the reality on the ground in Powys and question whether the Minister fully understands how cross-border care works.

Mr Chadwick said: “Patients do not care which side of the border they are treated on. They care about getting treatment when they need it.”

He added: “If the Welsh Government is serious about reducing waiting lists, it should be making use of every available appointment and operation slot.”

"Spare NHS capacity exists across the border. Powys patients should benefit from it, not be forced to wait longer because of budget calculations that only result in greater costs in the long term.”

"I would encourage the Minister to again look at the detail of what is happening on the ground in Powys and the consequences it is having on not only individuals but the health care system as a whole and change course,” he added.