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Department of Health

I am talking about the past few years, when Staffordshire frequently bailed out Shropshire. Perhaps that was before the hon. Gentleman’s time. Paying off the deficit is going to be very tough for Staffordshire Moorlands PCT. It will not just mean stripping out inefficiencies; there are bound to be service cuts. However, I have great faith in my PCT’s leadership, who will ensure that they work closely with the community to ensure that the cuts that they have to introduce will have the least possible impact on patients. I very much support the Secretary of State’s statement about reducing unplanned emergency admissions and saving the NHS money. My PCT has embraced that enthusiastically—for instance, through the anti-falls programme, but particularly by using community matrons to intervene in the community to pre-empt unplanned emergency admissions. The PCT has saved about £0.5 million by such investment in community provision. However, the avoidance of emergency admissions now attracts half the funding that it did previously, so from a financial point of view there is less incentive to invest in community provision and it is less cost-effective to do so. That will hardly encourage best practice, as the Secretary of State wants to do, and it will undermine future investment made by my PCT in preventive measures such as the anti-falls programme and the employment of health visitors and suchlike. Similarly, we have an ambulance service in Staffordshire which, through its superior training of paramedics and community first responders, prevents huge numbers of admissions to hospital by treating people at home. That is better for the patient and saves millions of pounds for the NHS, and it does not crowd out elective surgery at the hospital. Yet that ambulance service is threatened with merger, involving a dilution of staff skills and a reduction in their service standards. If we are serious about increasing and improving out-of-hospital care, we have to reward PCTs and ambulance trusts that are excelling in those fields. We should not merge them with other organisations that do not share their focus and delivery. I hope that when we come to the end of the public consultation on Wednesday 22 March, the strategic health authority and the Secretary of State will listen to the overwhelming response of people in north Staffordshire who say that they want to create a local north Staffordshire PCT and do not want a gigantic Staffordshire-wide trust. They also want an independent ambulance service working within the west midlands that would act as an exemplar to other ambulance services and help to create far better ambulance services country-wide.