---

Primary Care Trusts and Ambulance Trusts

I thank the Minister for advance sight of his statement. The Government abolished health authorities four years ago and created primary care groups and primary care trusts, and they are now merging them back together to create health authorities. Were the Government right to abolish health authorities, and are they right to recreate them? Is that what the Minister is telling the House? Or did they make a mistake four years ago, and will he admit that to the House? Can the Minister provide evidence of where the£250 million cost saving will come from, given that the Select Committee on Health was very sceptical that savings on that scale could be achieved? He did not answer the Conservative Front-Bench spokesman’s question about the number of redundancies that are implied by a £250 million annual saving. How many people will lose their jobs? On responding to local consultation, I thank the Minister for listening to some very effective lobbying from the west of England, which has resulted in keeping PCTs coterminous with social service authorities. I welcome that fact, because I was sceptical that the Government would listen on that point. I assume that he already knows that I was pressing for that. I also welcome the fact that, following recent political trends, the south-west of England has turned from blue to orange. On coterminosity, the Minister said in his statement that about 70 per cent. of PCTs will be coterminous. Is there a limit to that, or will he go further? What is the restriction on having 100 per cent. coterminosity and having real integration of health and social services? How far will the Government go? What are the promises of PCTs that have been abolished worth? Many of my colleagues are worried that, although they have been promised things by existing PCTs about new community services, the successor bodies may well say that they are not bound by the promises of the predecessor bodies. Can the Minister give us an assurance that, when an existing PCT has made a promise, the successor bodies will honour that promise? Finally, on the ambulance trust mergers, what confidence can people living in rural areas have that the very large ambulance trusts will not inevitably concentrate on urban centres? Whereas small trusts could respond to local circumstances, larger ones may neglect rural areas to hit their performance targets.