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Health Care in London

I hope that I can give the reassurance that decisions will be made locally in relation to local needs, local patients' choice and GP referral decisions. My visit with my hon. Friend to his constituency, and the example of Queen Mary's hospital in Sidcup, begin to give the lie to the Government's amendment—in that none of the changes will happen unless and until new services have been developed. That is far from the case at the moment, and it is assumed that patients who are denied access to hospital services will simply be accommodated elsewhere in the community at a lower cost. The assumptions are literally heroic, stating that it will be possible for 55 per cent. of out-patient and 60 per cent. of accident and emergency attendances to take place in the community rather than in the hospital. The Government cite the National Primary Care Research and Development Centre, which just over two years ago undertook a study on care closer to home, but that does not for a minute justify the 55 per cent. out-patients figure. All the examples are small-scale, and none systematically demonstrates a reduction in cost if one maintains quality, not least because good-quality community services often have to be delivered by the same hospital specialists—or certainly with them, and as a result of their training and co-operation. The Government cannot point to any evidence that supports their assumptions.