---

Family Doctor Services

I am grateful to the hon. Gentleman for his thoughtful speech. I think that he puts his finger on a difficulty that, if we are honest, all political parties have with these issues: on the one hand, we seem to have the shibboleth of local control and local accountability; on the other hand, we have things such as health inequalities, which we would like to address with different mechanisms. Perforce, such mechanisms are often seen as top-down control—and it seems to be another shibboleth that we should decry that sort of control. Will the hon. Gentleman explain how one does that balancing act? It is difficult for any of the three main parties to balance in their policies the top-down element, which, unlike local control, we think we do not like, bearing in mind some of the results that flow from local control—most notably displayed in the phrase ““postcode lottery””.