---

Health Care in London

I am grateful to my hon. Friend, who makes a very important point. One of the assumptions is a 60 per cent. transfer of accident and emergency cases out of A and E and into the community. A study on primary care and emergency departments commissioned, and published last Friday, by the Department of Health, said that, of arrivals at A and E,""We found that the proportion that could be classified as primary care cases was between 10 per cent. and 30 per cent."" It went on to say:""There is good evidence that the majority of patients choose the correct level of care. A few do not and it is always a risk to plan for the few rather than the many."" In north-west London—we have seen the documentation on that area—it is astonishing to make this proposal and talk about such a massive transfer out of A and E, given last year's figures. In Chelsea and Westminster the rate of A and E attendances has gone up by 4 per cent.; in Ealing the figure is up by 1 per cent.; for Imperial, taking Charing Cross and Hammersmith together, it is up by 9 per cent.; in North West London Hospitals it is up by 15 per cent.; in Hillingdon it is up by 6 per cent.; and in West Middlesex it is up by 5 per cent. All those hospital emergency departments have people pouring in. It is simply not true to say that there is any evidence to support the proposition that the services in the community that would justify what is being proposed in terms of the closure of emergency departments have been put in place.