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Health Care in London

As ever, I agree with my hon. Friend and good friend. The report that was produced on behalf of the primary care trust last week shows how it estimates that between only 10 and 30 per cent. of the people who currently attend A and E could be properly attended to at one of the devolved clinics, as we might describe them. However, up to now the basis of the Darzi report has been that between 50 and 60 per cent. of people could be safely dealt with at such clinics, and I do not agree. I am simply not convinced. The whole basis of the concentration of stroke provision and major trauma provision, which I strongly support, is that practice makes perfect, but apparently practice does not make perfect in A and E any more, because the people who have a lot of practice at a large A and E will be substituted by people who have a lot less practice at clinics in the community. So the closure does not make sense in terms of the practicalities or, indeed, the money. The idea that there was widespread, successful consultation of Londoners over the whole Darzi thing is really preposterous. About 1,800 Londoners—and there are rather a lot of us—expressed support for the Darzi proposition, and about 1,700 said that they did not want it, so the view was far from unanimous even among those who were consulted. I find that outcome about as convincing as Lord Ashcroft's protestations about his tax status, and we all know what that indicated. Unfortunately, these aspects are bringing into disrepute a great deal of the achievements that the Government have brought about in the years that we have been in office. At the meeting I went to, when we had to listen to the burblings of some of the people who are proposing what is happening at the Whittington, nothing much was said about improving clinical performance; it was all about saying, "Oh, we think we're going to be £500 million down." When they were pressed to explain how that was going to happen, they could not come up with any satisfactory explanation. I can only assume that they are absolutely convinced that there will be a Tory Government and that there will therefore be a £500 million-a-year reduction in the money that is available, because they could not possibly conclude that from anything that the Labour Government have been committed to. We need to look at the functions of NHS London. It is NHS London, not NHRS London: it is there to help clinicians in London to improve the services, not to be a national health reorganisation service for London. A lot more attention needs to be paid to what local people want. In talking about A and E, I come back to the thing that I have been obsessed with for all the time that I have had an interest in this issue, and that goes back a very long way—if we want to make A and E departments more successful, let us put some GPs in there to deal with the folks who choose to turn up. People do not want to be told, even by clinicians, that they should not turn up at their local hospital. If they want to turn up for GP services, as well as strictly A and E provision, that should be fine by us, and it would be a proper response to the situation that we face. I strongly welcome what the Minister said about being far from convinced of the merits of the closure of the A and E at Whittington hospital. One has to be careful what one says when one is a Minister, and what he said far from overstates the reaction of most people in the area and, according to all my sources, the reaction of most of the clinicians who are working at the Whittington and want to continue to do so. I welcome what he said, and I think he had better press on with it. We cannot leave this to bureaucrats. It is no good leaving things to bureaucrats, because when they get it wrong, they do not have to stand at the Dispatch Box to explain. Ministers have to do that, so Ministers should take responsibility right the way through. The people who take the decisions should carry the can, and the people who carry the can should take the decisions.