Dr. Richard Taylor: Emergency and accident facilities are the crucial issue. We cannot understand why small hospitals such as Hexham and Kendal have retained blue light services. I commend to the Minister the work of the Royal College of Physicians and Andy Black of Durrow Management. They have produced models in which some emergencies are still dealt with in local hospitals. We believe that a model could be designed for the whole country, based on the Andy Black model and on what is happening at, for example, Hexham, Kendal and Bishop Auckland. That would defuse the terrible anxiety about the loss of emergency services. We do not know
Ms Blears: I am aware of the work to establish other models for accident and emergency care, and am greatly interested in the outcome of that. It is important not to close our minds to a range of ways in which services can be provided. The work is relevant across the country and, in particular, in rural areas that sometimes do not have access to the types of centres that are available in urban ones. Everyone should have the right to receive the best possible services in the most appropriate clinical setting. Local health authorities are working together with primary care trusts and everyone in the local community to achieve that.
The hon. Member for Mid-Worcestershire (Mr. Luff) expressed concern about the appointment of the chair of the trust. I can reassure him that appointments are completely in the hands of the independent NHS Appointments Commission. The process will proceed. There is no question of chairs and other trust members being placemen of the Government or anyone else. I am sure that an excellent appointment will be made and he or she will take forward the health service in that community.
The proposals by Worcestershire health authority will ensure that local people are able to receive appropriate care in their local communities. Change is always difficult in the NHS. There are different and conflicting pressures from, for example, the royal colleges on training accreditation and from local people. The difficulty is to ensure that we balance and reconcile those different interests and that we do it with an eye always to high-quality services for local people. I meant what I said in the discussion document: we need to put patients and citizens at the heart of our national health service and ensure that their views are expressed, listened to and acted on. That is in the best interests of all our communities and, indeed, of our health service. If we go forward in partnership, we can avoid conflict and come to a resolution