---

St. Bartholomew's Hospital

: If the hon. Gentleman will forgive me, I will not give way. I listened carefully to what he said, and he will have opportunities after the debate to make further representations to me. People tell us that they want more services delivered away from hospitals and closer to them in communities. For that reason, the local NHS in this case was asked to commission the independent review that is ongoing of the proposed redevelopment of Bart's. That is not intended to be a long review or to add costs in the way described; I know that fears exist about the implications of it for the overall scheme. We genuinely want to ensure that we have the right balance of services in north-east London before making a commitment that will last for 42 years, which the health service in London will be expected to meet and which will expand cardiac and cancer services. I hope that the hon. Members for Cities of London and Westminster and for South Cambridgeshire (Mr. Lansley) agree that that is a sensible step to take. Any new proposal must offer the best value for money and be affordable by the health economy. When the business case was submitted to officials, there were still a number of outstanding commercial issues to resolve. That is not intended as a criticism of the trust or of those engaged in drawing up the bid: it is perfectly normal to have outstanding issues at this stage of the process. However, because a scheme of this size and complexity has never been undertaken in the NHS before, it has taken longer than normal, and longer than we would have wanted, to resolve the outstanding issues satisfactorily and to finalise the review of the business case. Part of that process has resulted in our request to the strategic health authority further to demonstrate the need to expand cardiac and cancer services at Bart's. North East London SHA has therefore commissioned an urgent review to ensure that the NHS in east London has the right hospital capacity to meet the needs not only of east Londoners, but of those in the City of London, who have an interest too. There have been significant reductions in waiting lists in recent years, and a great deal of money has been expended. It would be reckless to go ahead without that proper scrutiny. I hope that those who are debating with me this afternoon agree that we should all be prepared to accept that hospital and community services will, from time to time, need to change if we are to continue to fulfil patients' needs, improve services and meet patients' aspirations as I have described.