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Health Care in London

I think it would have a number of important differences. First, it would be led at a local level by GPs. The Minister has said that clinicians are discussing it among themselves, but we think that that is not good enough. Of course clinicians need to be involved, but so do GPs and, critically—this has come across in every speech made tonight—so do the public. People feel like they are going to be presented with a fait accompli when they have had no opportunity for input at an early stage. That is why we have had the debate today—to start a proper debate that the public can be part of. If Ministers ignore that, they will be going down a very dangerous route. Serious questions have been raised today about the reliability of the funding projections on which the reorganisation is based. The assumptions are questionable —they have even been questioned by the work of the King's Fund, for example, which seems to undermine whether the assumptions we have will actually work. Above all, it seems to be a financially driven process. We need a careful, considered assessment of London's health care needs and of how they will change over the coming years. In particular, we have heard concerns about the fact that we will see patients transferred to community services when those services, or polysystems, as they are being called—more impenetrable language that the public can never understand—are not even necessarily in place. That is a real concern. We heard the concerns expressed by my hon. Friend the Member for Enfield, Southgate (Mr. Burrowes) about what has happened in his constituency, which flag up that we are right to be concerned. I shall make progress, because I know that the Minister will want to answer some of the concerns that have been raised tonight. Of course, the other issue that has emerged is, as has just been mentioned by the hon. Member for Kingston and Surbiton (Mr. Davey), that the approach has been secretive. We have all urged our local NHS providers to be transparent with the public about the process. Whatever the Minister says, it is not being driven locally—it does not even seem to be driven clinically. The public seem to have no access to the debate that is going on in the inner recesses of the NHS, and they are deeply concerned about that. We need a different approach that is rooted in local communities and that involves GPs, clinicians and, critically, the public. The conclusion to the debate must be that the current process has been discredited and should therefore be halted. The assumptions regarding the solutions that have been worked up about moving services into the community are flawed financially, the focus is apparently on cutting front-line services rather than on challenging the massive growth of bureaucracy in the NHS that has occurred under Labour, and the public have no involvement in the process at the very time when they should be central to it. That simply is not good enough. As we have heard, there is simply no transparency. I take this opportunity to urge NHS London to start being transparent and to start communicating with the public on the ground in the communities who are so worried about what is going on. Instead, the Minister has tried to justify the process when he should be challenging it. There has almost been unanimity across the Chamber regarding our concerns about this process. I conclude by saying that we all have a chance tonight to represent those concerns on behalf of our constituents. If we do not take that chance, I am sure that our constituents will represent their own concerns about this issue at the ballot box.