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Kali Mountford (Colne Valley) (Lab): Again, we start a debate with collective amnesia. Hon. Members told my right hon. Friend the Secretary of State that she should not be able to sleep at night. If that is the case, Conservative Members must have had 18 years of nightmares. My hon. Friend the Member for Crawley (Laura Moffatt) gave a good account of past failings in the national health service. The Opposition have a clear strategy of running down people's opinion of the NHS to pursue a more insidious agenda. The speech of the hon. Member for Banbury (Tony Baldry) was an example of that. The debate is not genuinely about overall investment in the NHS but about certain people's concerns not being met because of a restructuring of the way in which health care is provided. Yet, if Conservative Members read some of the diaries of their right hon. and hon. Friends who used to be Ministers, they will realise that some of them openly admit political interference in the formula. [Hon. Members: "Who?"]

Mr. Graham Stuart rose—

Kali Mountford: I shall not give way. Hon. Members can go to a library like anyone else.

Mr. Andrew Turner (Isle of Wight) (Con): Will the hon. Lady give way?

Kali Mountford: I have made it clear that I am not giving way.

I am glad to say that I believe that the formula as it is now constructed ensures that people in the most deprived areas get the most funding. That is the right
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way forward. Each person in my constituency gets £7 less than in the neighbouring constituency of Huddersfield. That is hardly surprising since the economic indicators clearly show poverty in Huddersfield and relative wealth in Colne Valley. We make no excuses for that; the formula is perfectly fair.

We have also ensured locally based provision of health services through the PCTs. All hon. Members should welcome that. Conservative Members often talk about a small state and large people, yet suddenly today, they demand state interference at the most local level. Decisions about the local delivery of services should be made locally.—[Interruption.] I am making a case.

In my PCT, there was huge consultation about the delivery of services. Local people made clear what they wanted from their health service. Thousands of people wrote to me and a case was clearly made to the Government. The Government agreed that the services should cater to local people's needs. People understood that they could join with Huddersfield, which had more money spent on constituents per capita, yet they still preferred locally based services.

Mark Simmonds: Does the hon. Lady agree that she is making a good case for abolishing central Government targets for health care?

Kali Mountford: No, I do not agree because there must be a balance between ensuring that taxpayers' money is spent on the right priorities and local needs. There is no contradiction in stating Government priorities, which, in my experience, usually reflect the concerns of my constituents. For example, let us consider cancer care. It was clear that my constituents wanted the same rate of recovery as the rest of Europe experiences. They were not getting that but we are now well on the way to achieving our targets. I am pleased and proud about that. The hon. Gentleman makes it appear as though my constituents did not want such targets. If they had not wanted them, I would not be here today.

We are conducting several health reviews in my constituency and I have some concerns about them. Local people should be able to make decisions, not in the interests of doctors or administrators, but in those of patients. That is why I asked the hon. Member for Romsey (Sandra Gidley) about her view of maternity services. She might be interested to learn that her colleagues on Liberal-run Kirklees council agree with me about midwife-led units. We need to learn much more about how they can play an important part in maternity services if they are properly supported. My constituents are concerned about how that service can be delivered to their benefit. Most of them want a choice in their services, and maternity services are as good an example as any of how choice can work.

A woman who expects to have a perfectly normal birth might want to have her baby at home. That is quite proper, and she is entitled to do that. Should the community decide that it wants a midwife-led unit, it will make that case clearly to the local PCT in the local consultation. People are right to demand from me—as I demand from the health service—that such a unit be run properly and with the right support. We should not therefore set up a maternity service that delivers only 500 babies a year, when there are 3,000 a year being
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delivered in the Huddersfield royal infirmary. We have to take into consideration not only the number of babies being born in Huddersfield but the fact that we might also have to transfer patients, in the middle of what was expected to be a normal delivery, to the newly built hospital in Halifax, which we are very proud that the Government were able to deliver—no pun intended.

We have to balance the new ways of delivering health and patient care with value for money and with what the public want. The public have made it very clear to me that, if there is to be a midwife-led unit, they want it to have full hospital support nearby.

Mr. Burrowes: The hon. Lady began her speech by talking about collective amnesia. Does she share my concern about the amnesia of the Government, who, before the election, promised that the future of our local accident and emergency unit in Enfield would be safe and secure in their hands? Six months on, however, there are plans to cut that service. Is not that an example of amnesia, in that the Government now appear to support that closure?

Kali Mountford: What would be important would be for the hon. Gentleman's constituents to have a local consultation about accident and emergency services, similar to the one that took place in my constituency. The services there have now greatly improved. I can speak only for my own constituency and my own hospital, but no doubt he will make his own case for the hospital and the accident and emergency services in his constituency.

I understand it when health managers tell me that they want to review services because they want to make them more effective and efficient, safer to deliver and better for patients. They make it clear that they are doing that not because they feel that they are underfunded but because they think that there is a better way of delivering the services. I tell them that they might be right in some cases. However, if they continue to propose new services that, in my constituents' view, favour the administration of the hospital or the doctors to the detriment of the services that my constituents want, we need to listen very carefully to the patients at that point.

In 1996, when the then Government proposed to close the local community hospital, I opposed the closure. The hospital remained open. A clear promise was made to that effect by this Government, and the hospital has remained open. Not only that, but it is flourishing and growing daily. It provides new services that were never thought of before. It used to be regarded as quite a shabby place that the local community paid for out of donations. They felt that those donations made it their own hospital, and they were proud of it. Now, because of this Government's commitment to community hospitals, it delivers surgery day care, which it did not do before. I believe that that hospital is the kind of place that could house a maternity unit, because it would have the support of obstetricians, paediatricians and anaesthetists nearby. My constituents—and the midwives themselves—tell me that they want the kind of service that will ensure that all deliveries are safe.

Conservative Members ignore the fact that we ought to be measuring the positive outcomes of patient care. Patient care changes and develops over the years, and it
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becomes better. As it does so, we have to adapt to the introduction of new services or treatments or—I have forgotten the other word.

Mr. Edward Vaizey (Wantage) (Con): Cures.

Kali Mountford: The hon. Gentleman has helped me greatly.

As medicine changes, we have to change with it, but we must not be led by the nose into thinking that there is only one way of doing things. Services must be locally based and they must respond to local needs. Our consideration of cost-effectiveness must take into account patient outcomes. "Patient outcomes" sounds like horrible management-speak for people getting better. If we look at the number of people getting better, we can see that thousands more people are being treated—

Mr. Deputy Speaker (Sir Michael Lord): Order. The hon. Lady's time is up.

6.15 pm

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