I can't see how flying bone marrow over in a plane and then down the motorway to Cardiff can be that expensive Leukaemia patient Alan Francis

The marrow would have been taken from a donor, frozen and flown to south Wales for the treatment on Alan Francis, 68, of Llanelli, Carmarthenshire.

Health Commission Wales (HCW) would not comment on an individual patient but said it had "significantly" increased investment in the transplant service.

Health Minister Edwina Hart has asked for a report on Mr Francis' case.

Doctors had told him the chances of finding a donor were 170,000-to-one, but found a perfect match on the other side of the world.

Health economist Siobhan McClelland said that with limited resources HCW had to decide on priorities, which could be "difficult" for public and patients to accept.

But a more transparent decision-making process would be better, she said, as it was difficult to know why this case had not been funded.

Mr Francis, who said he had always kept himself physically fit and played a few games for Llanelli RFC in the 1960s, was diagnosed with leukaemia 10 years ago and has since beaten it twice.

But he has been told by doctors that usually after the second time it will return within two to five years.

Frozen

Mr Francis said after a search for a UK donor, a match was found in a 43-year-old man in Australia last November.

Alan Francis has been treated at the University Hospital of Wales

The transplant was due to take place in four weeks, but Mr Francis was then told funding was being withheld.

He said: "The delay was nothing to do with the Australian, nothing to do with me, we were both okay because we had to have tests."

"It's enough worry to know what I've got to go through - let alone this," he said

Health Commission Wales has increased the level of investment in bone marrow transplantation significantly over recent years Health Commission Wales

"I can't see how flying bone marrow over in a plane and then down the motorway to Cardiff can be that expensive."

Ms McClelland said HCW often had to deal with "high cost, low volume services" issues which were particularly emotive.

She said: "People say they don't want to put a price on life and it should not be about money, but at the end of the day, it is about money and making sure we spend that money as effectively as possible."

HCW's decision-making process was not well explained to the public, she said.

She said: "Is it the case it is going to cost extra money to transport from Australia than if it was transported within the UK... does that make it too expensive?

"Is it because of this gentleman's age? Are they making the decision because of the amount of years he has got and as a consequence doesn't warrant payment?

"Or is it that this condition is recurrent so they feel it may not be clinically effective? We don't know the answer. They say they won't comment on individual cases and don't give us an indication of what the rationale is."

The Welsh Assembly Government said: "The Minister for Health, Edwina Hart, is aware of this case and has asked for a report on the matter."

A spokesperson for Health Commission Wales (HCW), which co-ordinates specialist health services, said: "HCW has increased the level of investment in bone marrow transplantation (BMT) significantly over recent years, including investment in the service based at University Hospital of Wales.

"HCW commissioning of BMT is consistent with the published and evidence-based recommendations of the European Bone Marrow Transplantation group."