Patients, staff and visitors will be able to park for free at almost every NHS hospital in Wales by the end of 2011. The Welsh Assembly will also confirm this afternoon that free parking will be available to patients from April 1.

Those hospitals whose parking is run by private companies will also have to reduce costs until their contracts expire.

The changes, the first in the UK, have been welcomed by patient groups but trusts say that they may come at a cost to patient care. Nearly £5.4 million was collected by NHS trusts in Wales from hospital parking charges in 2006-07, but the reforms will mean that by the end of the current assembly term in 2011, only four hospital sites of 130 should still have parking charges in place.

The British Medical Association (BMA) last week demanded that hospital car park charges be scrapped, claiming that they are "a tax on the sick".

The Welsh NHS Confederation, which brings together all Welsh NHS organisations, said the reforms would “inevitably” add to the pressures on trusts.

Today’s announcement will fulfil the Assembly's commitment to reform charges for hospital parking, which was set out in the One Wales document outlining the agenda of the Labour and Plaid Cymru coalition.

It also adds to the disparities in NHS policy between the four home nations. All patients in Wales get free prescriptions; the English pay an average of £6.85 an item. Scotland spends more on NHS care — £1,610 per head of population last year — than anywhere else, with Northern Ireland spending the least (£1,550 a head).

Free prescriptions are already available for vulnerable older people in Scotland, and the SNP is planning to extend this to all patients. Certain drugs are also available on the NHS in Scotland but not in England and Wales, where different calculations are made about cost-effectiveness.

Despite these differences, the King’s Fund think-tank says it was almost impossible to compare health outcomes in the four countries because they collect data differently.

In an address to the Welsh Assembly this afternoon, Edwina Hart, the Health Minister, will say: “Car parking charges fall heavily on people frequently attending NHS hospitals, whether they are patients, staff or visitors.

“They are at best an inconvenience and at worst an unfair expense. Over time all NHS patients, visitors and those who care for them will not have the expense or inconvenience of charges. By the end of the current Assembly term, the vast majority of NHS sites will have free parking for all.”

Cath Lindley, general manager for Macmillan Cancer Support in Wales, said: “Cancer patients have long been calling for parking costs to be scrapped.

“On average, cancer patients make 60 trips to hospital from diagnosis to treatment to follow up and, as a result, they are hit particularly hard, both financially and emotionally, by travelling costs and unfair parking charges. These reforms would go some way towards reducing the financial burden that can come with a diagnosis of cancer.”

It is expected that the additional costs to the NHS in Wales will be met from within annual NHS funding allocations.

It is also understood that trusts will be required to submit plans on how they will deal with additional costs, potential increases in demand, promotion of green transport modes and the potential use of spaces by commuters and shoppers.

Mike Ponton, director of the Welsh NHS Confederation, said: “It costs a lot of money to run car parks and the dilemma now is how to meet these costs without impacting on patient care.

“It will inevitably add to the pressures placed on trusts to provide services and balance the books. It will be even more important now to find new ways of controlling car parks to avoid misuse, particularly where hospitals are near town centres.”

There are no plans to abolish the charges in England, although a Department of Health spokesman said “all Government polices are always under review”.

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