Doctors could already be leaving for hospitals across the border

Staff working in the new-style hospitals across the border could br offered better wages and terms than their Welsh counterparts.

Medical staff in Wales fear that could lead to a brain drain of talent and expertise.

Doctors in Wales are pressing for new consultant contracts to be agreed to counter the threat.

Foundation hospitals, which would be semi-independent and have the power to raise their own money, are supported by the Labour government at Westminster.

But they have been ruled out by the Welsh Assembly Government.

Salary structure

First Minister Rhodri Morgan has already warned that Welsh hospitals would suffer as a result of a two-tier salary structure in the UK health service.

The British Medical Association (BMA) in Wales will voice its concerns at its conference next week.

Dr Carl Wright, a consultant in radiology at Glan Clwyd Hospital, Bodelwyddan, said he feared that some staff were leaving Wales.

There are already many vacancies for nurses in Wales

"I think it's happening already," he said.

"Consultants have moved from Welsh hospitals.

"It's multi-factorial - salaries are only part of it and working environment is also significant."

The problem could be particularly acute for hospitals closest to the border, and specialist registrars are said to be looking toward Cheshire and Liverpool.

The BMA opposes foundation hospitals in principle and says it fears an "Offa's Dyke" of the new institutions in neighbouring English areas.

Avon has been approached to apply to set them up, and Shrewsbury, Hereford and Chester are said to be interested.

They (doctors) are not leaving. There's always been cross-border movement Jane Hutt

The Royal College of Nursing is also worried about the impact on staffing levels. There are already hundreds of nurse vacancies in Wales.

Senior nurse Gareth Phillips, of Anglesey, spends his spare time looking after his ducks and geese, because, he says, a low salary forces him to rely on home-produced food to keep his cost of living down.

Mr Phillips has worked in a foundation hospital in Canada, and said he would not think twice about moving away from Wales again.

He added: "If foundation hospitals are offering better conditions and salaries, foundation hospitals are going to be able to pick the most experienced nurses and we are going to get a drift of nurses across the border."

But Welsh Health Minister, Jane Hutt, said improvements in the NHS in Wales would stop any cross-border brain drain.

"We've decided not to have foundation hospitals in Wales and we have our own plans in place," she said.

"They (doctors) are not leaving. There's always been cross-border movement.

"Doctors and nurses are coming on board and we are training many more."

Talks on consultants contracts have stalled in England, but the BMA said negotiations with the assembly government on the Welsh equivalent were going well.

As well as addressing pay, the contracts would set limits for private practice and regulate the amount of managerial influence on consultants' schedules.