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Mr. Peter Bone (Wellingborough) (Con): Will the hon. Gentleman give way?

Mr. Reed: If the hon. Gentleman does not mind, I want to get on. If he has any telling or pressing points, we can discuss them outside the House or he can write to me.

I urge the Minister and his Department to pay close attention over the coming months to this unfolding issue and, in particular, to the principles that I have outlined: equity of access and of standards. At this point, I ask the Minister to assess the funding formula for the NHS within the forthcoming White Paper and ensure that issues such as socio-economic factors and sparsity of population are addressed.

Returning to the PCT, only this Friday I met clinical staff at Millom community hospital and the friends of Millom hospital to discuss the PCT's proposals. I expected anger, anxiety and dejection among those whom I was to meet, but I must extend to the Minister their sincere thanks and appreciation following his intervention. Like me and my hon. Friend the Member for Workington, the staff, friends and users of Millom hospital were delighted to learn about the Minister's intervention and are now hopeful for the future, given the plan that he has identified. The people of Keswick, Maryport, Cockermouth and Workington are also equally grateful.

The Minister will correct me if I am wrong, but the plan states that West Cumbria PCT is in line for a record cash boost over the next two years totalling more than £30 million, which is nearly twice this year's underlying deficit. Local health chiefs must spend that money wisely following a much needed detailed debate and consultation on how to redesign services for the better. Over the next three months, the consultation in west Cumbria, which, as I understand it, will be undertaken by the strategic health authority rather than the PCT, will explain how the existing infrastructure of community facilities will be expanded. The Minister will visit west Cumbria in the new year to ensure that all of the above takes place.

As a result, the PCT's proposals have, as I had hoped, been withdrawn. Let me assure the Minister that at no point did anyone believe that those proposals belonged to the Government. There is widespread acknowledgement of the fact that Labour is the only party with the interests of the NHS at heart. The Minister might be interested to learn that in my constituency at the last general election the Conservatives campaigned on a platform of reduced health spending and health service privatisation, and received their worst result for almost 100 years. The persistent and continual Conservative threat to the health services of west Cumbria rightly led to the Tories in Copeland receiving the lowest number of votes since the NHS was introduced. That damning condemnation
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of the Tories' health policy, and attitude, shows precisely how the people of Copeland and west Cumbria value their health services. I can put it no better than a farmer constituent who told me at the weekend that he would rather let a fox look after his chickens than let the Tories look after the NHS.

Two groups are central to any consultation and redesign of services in west Cumbria—patients and staff. Patients are not slow in coming forward with their views. Civic engagement is evidently lacking in several policy areas, but health is not one of them. However, sufficient consideration needs to be given to the views, hopes, concerns and often wise and insightful suggestions of front-line service providers in west Cumbria. Having spoken to a good number of health care professionals from across a broad spectrum of services and professional standing, I know that all too often they do not feel that their knowledge and experience is valued, or even considered relevant, when management boards launch consultations. I urge the Minister to ensure that the new consultation in west Cumbria pays sufficient attention and proper regard to the views of health care professionals, who will after all deliver the model of care that is agreed on.

West Cumbria PCT, against a background of record investment, is projecting a recurring deficit for next year of approximately £15 million. It is absolutely right that all trusts should be expected to balance their books. However, the fundamental question that lies at the heart of this debate is this: where has the money gone? I know that the Minister is as keen as me and my hon. Friend the Member for Workington to find the answer, and I hope that he can help us in that endeavour, particularly in the light of the effective doubling of investment since 1997. It is clear that the various trust boards serving west Cumbria are not working together. West Cumbria cannot sustain a viable health economy on that basis. I therefore ask for the Minister's help in achieving this for the benefit of all its health service staff and patients.

One of the most pressing medical issues in west Cumbria is its lack of dentists. I appreciate that that does not fall within the Minister's brief and is the responsibility of the Minister of State, my hon. Friend the Member for Doncaster, Central (Ms Winterton), but it is entirely relevant to the scope of this debate. I was recently honoured to welcome the university of Central Lancashire to the Westlakes science park in my constituency, where the university has established a significant permanent presence. UCLan has an excellent academic and medical research record. On the strength of that, I approached the vice-chancellor and the dean of the Westlakes campus to discuss the possibility of the university's helping to expand dentistry provision throughout west Cumbria. I am pleased to say that it has, as part of a higher education consortium involving Lancaster university, the university of Liverpool and St. Martin's college, submitted a bid to the Department of Health, which if successful would see a dental school established in west Cumbria.

This week, my hon. Friend the Member for Workington and I will write officially to the appropriate Minister to express our support for the bid and to outline precisely the direct and exponential benefits that such a development would have in west Cumbria with regard not only to dental provision but to the wider
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health service agenda. I hope that the Minister will urge his    departmental colleagues to give due detailed consideration to the bid.

I thank the Minister for the close personal attention and effort that he has given to this issue. I look forward to meeting him in west Cumbria in the new year, when I hope that we can progress the agenda of improving the health services serving west Cumbria in a sustainable, effective and permanent manner, while serving the needs and aspirations of patients and staff.

10.13 pm

The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): I sincerely congratulate my hon. Friend the Member for Copeland (Mr. Reed) on securing this debate. He has not been in this House for long, but he has already established himself as a powerful advocate for his local community and as a voice on health issues in particular. It was in one of my first debates as a Front Bencher that I heard his contribution to the debate about dentistry. If he will forgive me, I will pass on the comments that he made this evening to the Minister of State, my hon. Friend the Member for Doncaster, Central (Ms Winterton).

My hon. Friend has come to the House tonight to ensure that health care provision in his constituency is debated on the Floor. In congratulating him, I also congratulate my hon. Friend the Member for Workington (Tony Cunningham). His position on the Front Bench precludes his contributing to the debate, but he has contacted me on five or six occasions in the past week to give me counsel about how best to tackle the issue in his community. I should like to put on record my thanks to him for that. I also congratulate the Evening Mail and the Workington Times and Star on their excellent coverage of the debate. They have proved once again that they are a powerful voice for their local community.

In reply to my hon. Friend the Member for Copeland, I want to elucidate three lines of debate. The first is about the future finances for health care in his constituency. The second deals with the sort of health care provision that we might expect for that money over the next few years. The third is the manner and method whereby decisions about the future of health care will be made.

I should like to begin with a few words of thanks and praise for the front-line national health service staff in my hon. Friend's area who have seized the record investment and reform of the past few years to transform the health service locally. I was glad that he could celebrate their role so eloquently this evening.

The transformation of the NHS in my hon. Friend's constituency has been remarkable. Our funding for the NHS has been at great and record levels in the past few years. From £34.7 billion in 1997, we have increased spending by nearly £70 billion in 2004–05. What does that mean for my hon. Friend? He partly answered that question himself. In this financial year, West Cumbria primary care trust will get £145 million—a real-terms increase of nearly 6 per cent. in the past year.

If we compare such increases with those that we enjoyed—if that is the right word—under the previous Administration, we realise that, in their last five years,
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the average real-terms increase for the NHS was only 2.6 per cent. Indeed, in their entire 18 years in office, it was only 3 per cent.

My hon. Friend asked where the increased funding has gone. I am glad to be able to provide some answers. More than 150 consultants have worked in Cumbria and Lancashire strategic health authority area, in which his constituency sits, since 1997. More than 3,000 nurses and more than 1,800 health care assistants now work there, thanks to the investment that we have made since 1997.

With the extra staff come shorter waits. The number of people in Cumbria and Lancashire who wait more than six months for in-patient treatment has dropped by an extraordinary 90 per cent. since 1997. The number of people who wait 13 weeks for an out-patient appointment has dropped by more than 85 per cent. since 1998.

With shorter waits come better drugs, which, with the extra staff, have delivered longer lives. The mortality rate in west Cumbria from coronary heart disease has fallen by around 29 per cent.—an extraordinary fall. Cancer mortality rates are down by more than 9 per cent. since 1997. Good progress has been made but a great deal more remains to do. That is why extra investment is being routed to my hon. Friend's constituency.

My first line of argument is therefore about the increased resources to my hon. Friend's constituency. Funding in his PCT has increased from £112 million to £145 million. It is set to rise again from £145 million to £188 million in 2007–08. My maths makes that an increase of approximately £43 million. The underlying deficit at the beginning of the year was around £17 million; the increase over the next two years is more than two and a half times the current deficit.

I am glad that my hon. Friend mentioned the funding formula. He pointed out that it still contains a few imperfections in his constituency. He referred to socio-economic conditions and sparsity. It is right to review the formula again. I cannot promise answers in the forthcoming White Paper, but my right hon. Friend the Secretary of State for Health will introduce amendments in due course. Great investment has therefore been made.

My second line of argument is about what the money should buy in my hon. Friend's constituency and that of my hon. Friend the Member for Workington. Here we can see an extraordinary choice for the NHS over the next couple of years, in regard to how to use the new money to build local health services that meet the needs of constituents in a sustainable way. I would say to my hon. Friend the Member for Copeland that £45 million will buy some quite interesting choices, including how much to invest in hospitals, local doctors' services and community hospitals, and how much to spend on public health. Such choices have not been enjoyed by many NHS staff for some years.

My hon. Friend helpfully alluded to our manifesto commitment to deliver a new generation of community hospitals. We made a commitment to bring on line 50 new or refurbished hospitals over the next five years.
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These state-of-the-art centres will provide diagnostics, day surgery and out-patient facilities that are much closer to where people live and work. We made that commitment because we were aware of the great potential of community hospitals to enhance the delivery of health care for local people.

The new community hospitals will help us to move care and diagnostic services out of acute hospitals. They will also make it easier to put together primary and social care services, and encourage GPs to provide more specialist services. Modern community hospitals will provide safe services for people much closer to where they live, which is central to our vision for the NHS.

It is important, however, that these services should be provided in a sustainable way. My hon. Friend talked about the decades of uncertainty in his constituency; we must end that uncertainty. In May, the British people asked us to write a big cheque, but not a blank cheque, for the future of NHS reform. As we deliver care closer to people's homes and reduce the reliance on in-patient services, we must do so in a way that will stand us in good stead for the future.

The primary care trusts are planning to consult on proposals for changing the shape of community services, with the aim of delivering services such as an improved community nursing infrastructure that is better able to support people at home and will therefore avoid the trauma and cost of inappropriate hospital admissions. We hope that that infrastructure will make it easier to discharge patients following a hospital stay. We also want the services to include therapy units to provide multi-disciplinary assessment and centre-based therapy. This is all about putting care much closer to people's homes. My hon. Friend mentioned the role of acute hospitals in the future, and I hope that that issue will be reflected on in the consultation.

My third line of argument relates to the manner in which these decisions will be debated and, ultimately, made. In the months to come, the primary care trust will be seeking to understand how to take forward services in my hon. Friend's area. Its proposals will be judged against three simple criteria. First, are they safe, and will they improve patient care? Secondly, are they affordable in the short term, inside the envelope of the enlarged resources that we are making available? Thirdly, are they sustainable for the long term? I am pleased to say that the focus of the reshaped services will be on recycling community assets wherever practical.

I would add that, while health organisations must determine the broad strategies and face the challenges of matching the extra resources that we are providing to the provision of local services, it is essential that, as they go about answering those questions, they do not overlook the perspective of local service users. It is therefore intended that any proposals for change in community services in Cumbria will go to public consultation in the new year.

My hon. Friend alluded to the public listening exercises that we have undertaken as we have prepared the White Paper, "Your Health, Your Care, Your Say". Members of the public have been asked what improvements they wish to see in community health and social care. In the new year we will present our plans for reforming the way in which local health organisations
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are accountable to their local communities for shaping services, so that, we hope, these debates will have a different texture and tone in future.

Clearly, however—this is an important point for my hon. Friends—the debate on the outcome of the Cumbria consultation will have to include an analysis against recommendations included in the White Paper.

I know that my hon. Friend the Member for Copeland is concerned about emerging proposals in the public consultation. I am glad to be able to tell him that in order to review those options properly, and in the light of our ongoing work in the new health White Paper, the launch of the consultation has now been moved to late January or February of next year.

It is unacceptable for my hon. Friend the Member for Copeland to have had so little involvement in the development of plans to date. It is not acceptable that he is briefed about plans only through friends and colleagues whom he might have in the primary care trust. I therefore assure him that there will be no fait accomplis, cabals or decisions made behind closed doors. The national health service is under statutory obligations in relation to the way that it runs consultation and its conversation with the public. I am
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therefore pleased that the director of corporate affairs at the strategic health authority, who is extremely experienced in consultation exercises, will support the primary care trust during the process over the coming weeks and months. I will take a watching brief on the development of the proposals, and I understand that before the document goes for public consultation it will be shared with my hon. Friends the Members for Copeland and for Workington. I plan to make a visit in the new year to see how the consultation is unfolding locally.

I encourage my hon. Friends to continue to battle the corner for their constituents, and to engage with their local NHS on the way forward. Some decisions will need to be thought through carefully, but I am sure that my hon. Friend the Member for Copeland and his constituents will take the opportunity of the consultation exercise to make sure that their views and ambitions for the future are fully reflected in the blueprint that emerges.

Question put and agreed to.

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