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Accident and Emergency Services

Let me refer to the three points that were pertinent to this debate. First, the hon. Member for Southport spoke about a patchwork system that reflected the haphazard way in which emergency services are provided. The White Paper ““Equity and excellence: Liberating the NHS”” says it plans to develop"““a coherent 24/7 urgent care service in every area of England that makes sense to patients when they have to make choices about their care.””" My hon. Friend the Member for Hartlepool (Mr Wright) raised the issue of local communities understanding where they can best access care. The hon. Member for Newton Abbot (Anne Marie Morris) mentioned the standardisation of services around the country. I will come back to that point later, because I have great concerns about the rest of the White Paper, which is much more about localism and ways to provide service. Such a thrust might be a problem for the particular aim that the White Paper sets out around emergency care. Secondly, the hon. Member for Southport mentioned the need for baseline standards around waiting times, access and so on. I am again concerned with the thrust of the White Paper and that we may not have that baseline standard around the country. We have already seen the reduction in the waiting-time target in A and E from 98% to 95%, and I understand that it will be removed completely in the future. Thirdly, the hon. Member for Southport raised the issue of democratic accountability. I have to say that I raised an eyebrow at that point because it was clear that the Liberal Democrat party had got one of its manifesto promises in the coalition agreement, which was to have directly elected members of the PCT, but just a few weeks later, the White Paper basically ripped up that section of the coalition agreement. As I understand it, the democratic accountability is now to be through the scrutiny function of local authorities. Although I know that local authorities can carry out such scrutiny very well—we heard from my hon. Friend the Member for Hartlepool about the excellent scrutiny that has taken place in Hartlepool—I am concerned about how they will do it now that their budgets are being cut. To scrutinise health services will require further resources, not least because local authority members will need to be trained up. There is a difference between being able to scrutinise effectively the emptying of bins and so on and being able to scrutinise the very difficult, complicated and technical clinical health services.