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Mr. Yeo: In the four or five minutes that the Minister has left, can he explain why what was such a good ideabacked by the Department of Health, the strategic health authority and the local trustthe day before the election, turned out to be such a bad idea a month later?
Mr. Byrne: Unfortunately, I was not party to the plans developed before the election, but the important point raised by the hon. Gentleman is how the proposals currently on the table, which I understand will be decided on and published after the board meeting at the end of February, match up to Government policy. When the primary care trust reaches its decision and publishes it to the local community, it is important that it explains how the proposals that it has considered line up against the White Paper to be published shortly. As I said, that White Paper will contain a number of important principles. It will talk about how we shift money into preventive services, how we give people far more control of their own care, and how we ensure that health and social care work much more closely together.
Mr. Spring: The Minister is replying with great courtesy but, with respect, he is living in complete fantasy. The idea that there are integrated care teams and that people can exist to be part of those teams is nonsense because there is already a shortage of people in the county of Suffolk who could undertake that job. Although he is talking about increases, already, pre-emptively, at the main hospital in West Suffolk, 260 people have had their jobs removed in the past few months, and 55 beds have been removed. The crisis is deepening. With respect, his words are not linked to the reality on the ground. I am sorry to have the tell him that.
Mr. Byrne: I am grateful to the hon. Gentleman for that intervention but services will often need to be changed as there are advances in the way people in social care and primary care work together. Of course, we would expect services to be reconfigured. We would also expect, for example, more services that are currently located in acute trusts to move closer to the community.
If we look at the way in which outpatient services are managed in every other modern health care system on the continent and the amount that is concentrated in primary care systems, there is a great contrast with our own system. We need to learn important lessons from that. We need to look at how, in certain disciplines such as ear, nose and throat, dermatology and a range of others, outpatient services can be moved into services that are closer to home. That will sometimes require reconfiguration of services that are centred on acute trusts. That agenda is based on strengthening services and that is why I want to underline