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Access to NHS Services

I understand the hon. Gentleman’s point. As constituency MPs, we all face those pressures. The difference is that Conservative Members say the process is driven by financial constraints or by people in Whitehall; we say that the changes are necessary, as I have set out, for reasons such as medical advances, technological change and demographic change. There has always been reconfiguration in the NHS, and we must ensure that the NHS is capable of meeting today’s challenges and not the challenges of 1948. The decisions should be clinically driven, and they should not be driven by politicians. There is the question of how the public feel about the issue. Those who have not experienced the changes at first hand are not convinced that they are getting value for the extra money that they have contributed, and—this answers the point raised by the hon. Member for North Norfolk—there is more to do before the NHS achieves everywhere the levels of efficiency and effectiveness that are essential if we are to cope with the huge challenges that I have set out.