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Mr. Dykes: What does that mean?

Mr. Horam: As I am not a doctor, it is difficult for me to distinguish between which injuries will be treated by a casualty service and which will be treated at an A and E department. I think that my hon. Friends will be aware,

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however, that an A and E department would be dealing with trauma, life-threatening accidents and emergencies of that sort while a casualty service would be dealing with something less. That is the distinction that we are making.

Mr. Dykes: We are going backwards.

Mr. Horam: We are not going backwards.

I refer again to the assurances that were given by my right hon. Friend the Secretary of State to my hon. Friends. My right hon. Friend said clearly in June that a casualty service would be supplied with doctor cover. That was the essence of the promise, and that is exactly what we are talking about. My hon. Friends will be aware that that was set out in a statement made by Barnet health authority on 25 September. The statement was welcomed by my hon. Friend the Member for Hendon, North. He will recall the press statement that he issued at that time, in which he specifically welcomed the casualty service that Barnet health authority then stated clearly would be provided. That is the health authority service that I am talking about.

Sir John Gorst: Will my hon. Friend give way?

Mr. Horam: I do not want to mislead my hon. Friends in any way.

My hon. Friend the Member for Harrow, East asked specifically what the service would include. It will include precisely what was indicated in the statement of 25 September.

Sir John Gorst: The statement in which I welcomed the casualty department to which my hon. Friend is referring was before it was made perfectly clear by the local health authority that it would not be dealing with anything other than MATS placements. That made all the difference in the world. I was still operating on the assumption that my right hon. Friend the Secretary of State had defined things as we understood them on 11 June.

Mr. Horam: My understanding and my clear view, as someone looking at the matter from outside, as it were--obviously there have been conversations and discussions between my hon. Friends and my right hon. Friend for some time--is that what is being said here is exactly in line with the assurances given by my right hon. Friend. It would be wrong--

Mr. Dykes: Will my hon. Friend give way?

Mr. Horam: I have little time left. I have two more points to make before I shall give way to my hon. Friend.

First, the assurances that were given in June are exactly what is being delivered and what was intended by the health authority statement of 25 September. My right hon. Friend sticks by that. Secondly, my hon. Friend the Member for Hendon, North referred to the letter that both my hon. Friends received from my right hon. Friend only yesterday or today, as the case may be. I shall quote two specific sentences. My hon. Friend quoted one paragraph,

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I think somewhat unfairly, and I shall quote, as I said, two other sentences.

At the bottom of the first page, the letter reads:


that is, Barnet health authority. That was in the few weeks before the proposals that we have been discussing. The letter continues:


    "When it arrives I would of course be happy to discuss the proposals further with you in order to ensure that the demonstrator project reflects as accurately as possible the wishes of local people."

Secondly, my right hon. Friend adds:


    "In addition, therefore, to discussing the details of the demonstrator project with you, I would also like to discuss how these arrangements for the enhancement of healthcare in the Edgware area should be implemented . . . I trust that following your adjournment debate tomorrow we shall be able to make some progress on these issues."

Mr. Dykes: In the spirit of co-operation--I thank my hon. Friend for his remarks--will he guarantee and undertake now that what we decide in any further discussions will be done immediately and will not be restricted to the district health authority's list of the items

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that it would cover in a minor accident treatment service, but will be a full emergency facilities casualty unit?

Mr. Horam: I cannot commit my right hon. Friend to that now in the final two minutes of an Adjournment debate. My hon. Friend is an old enough hand to know that that is beyond my power. Clearly, that is something that we shall want to raise with my right hon. Friend. I was pleased at least that my hon. Friend the Member for Hendon, North said that in using the word "hope", and attaching it to the final sentence of the letter, there is an opportunity for further discussion on this extremely important matter.

Both my hon. Friends made the point strongly that there is a unique role for a local Member in these circumstances. I hope that they will understand that, even though I am currently a member of the Government, I, too, well understand the role of a local Member of Parliament in a situation such as this, and understand the position that they have adopted. I hope therefore that they will see that what my right hon. Friend is saying will enable them to discuss the matter further. I hope that they can accept that in the spirit in which it is offered.

Question put and agreed to.



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