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6. Mr. Henry Bellingham (North-West Norfolk) (Con): What recent representations she has received from NHS health trusts in Norfolk regarding the imposition of usage charges. 
The Minister of State, Department of Health (Jane Kennedy): I am unaware of any centrally recorded correspondence received from NHS health trusts in Norfolk regarding the imposition of usage charges.
Mr. Bellingham: The Minister will be aware that Queen Elizabeth Hospital King's Lynn NHS trust is currently £11 million in deficit, with ward closures and other cuts. Will it be possible for that historic debt to be wiped out through payment by results? Also, can the Minister confirm that if a trust borrows money from her Department it will have to pay a usage charge of 10 per cent., amounting to £1.1 million a year? Surely it is perverse and shortsighted to charge trusts penal interest rates; it will simply make difficult problems much worse.
Jane Kennedy: Usage charges were fully understood, supported and accepted by all parties when we realised the concept of the NHS bank.
Instead of standing on the sidelines wringing its hands over its deficit, Queen Elizabeth Hospital King's Lynn NHS trust has got to grips with it. It deserves congratulations and support for its efforts. It has hit its waiting-list target three months early, notwithstanding the deficit; it has taken steps to deal with the fact that non-elective stays in the hospital were one and a half to two days longer than those in other hospitals in the area; and it has taken really good steps to reduce by £2 million the cost of initiatives such as better bed management. All that is to the benefit of local patients.
Deficits are not a matter for standing on the sidelines and wringing one's hands. Local trusts and the health service must get to grips with the problem and manage itas the hon. Gentleman's local hospital has donein a way that delivers better services to local patients.
Mr. Bob Blizzard (Waveney) (Lab): Virtually all my constituents use James Paget Healthcare NHS trust in Norfolk, and, indeed, Norfolk Mental Health Care NHS trust. Neither of those trusts has complained to me about the matter raised by the hon. Member for North-West Norfolk (Mr. Bellingham). However, because in terms of the NHS we look in the Norfolk direction, the natural and obvious new configuration for primary care trusts is a merger between Waveney and Great Yarmouth PCTs. That is overwhelmingly supported by every strand of clinical and community local opinion. Will my right hon. Friend ensure that at the end of the consultation, the Secretary of State listens to that opinion and not to the strategic health authority?
My hon. Friend has made a good point. The consultation is under way, and we will listen carefully to what emerges from it.
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7. Mr. Gordon Prentice (Pendle) (Lab): How many accident and emergency departments have been downgraded since 2004 to take planned admissions only. 
The Secretary of State for Health (Ms Patricia Hewitt): According to reports from the NHS hospital trusts, there were 208 major accident and emergency departments in England at the end of 2004 and 206 at the end of September 2005.
Mr. Prentice: I hope that the blue light accident and emergency department at Burnley general, which serves my constituency, does not close. I know that there will shortly be a major public consultation, but what is the point of endless public consultations on these matters if we do not listen to what the public say?
Ms Hewitt: As my hon. Friend indicated, the East Lancashire Hospitals NHS Trust is engaged in pre-consultation discussions, looking at a range of options for improving services. Options will go out for public consultation, which I am told will begin in March 2006 at the earliest. All those public consultations are designed to listen to local people and as far as possible to build local agreement and consensus about the right way forward. Pending that consultation, I am sure that my hon. Friend will join me in welcoming the superb performance of the East Lancashire Hospitals NHS Trust, which has not only met but exceeded the 98 per cent. target for people being seen within four hours of arriving at A and E.
Dr. Richard Taylor (Wyre Forest) (Ind): Does the Secretary of State agree that the measures in the White Paper that move consultants and services from secondary care to primary care tend to threaten A and E departments, and what will she do to minimise that threat?
Ms Hewitt: I do not accept that the proposals in the White Paper are a threat to A and E departments. We have made enormous improvements to the performance of A and E departments. I remember, as I am sure the hon. Gentleman does, that not so long ago patients spent hours on end on trolleys in the corridors of A and E departments. That was absolutely unacceptable. We introduced the four-hour target. A lot of A and E consultants said that that could not be achieved, but now admit that it has been. It has been helped by the fact that 25 per cent. of all A and E patients are now seen in a walk-in centre or minor injuries unit, which is better not only for them but for the blue light cases who need to attend a major A and E department.
Mr. David Wilshire (Spelthorne)
(Con): A couple of years ago, the accident part of the A and E department at Ashford hospital, Middlesex in my constituency was axed. At the time, a local A and E consultant said that people would suffer and some would die. At midnight tonight, the emergency part is being axed as well, so more people will suffer and more of my constituents will
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die. Can the Secretary of State confirm that she is ashamed of the way in which her Government have treated my constituents?
Ms Hewitt: I simply do not recognise any evidence for the allegations that the hon. Gentleman is making. There was indeed a reorganisation in 2003 at Ashford A and E, when blue light services were moved to St. Peter's and, from tomorrow, Ashford emergency department will become a walk-in centre. There will be a substantial increase in day case surgery at Ashford hospital. By separating day case surgery from emergency surgery, much better services will be provided for patients who need elective care because their operations will no longer be cancelled. Blue light services and A and E services will be concentrated at St. Peter's. Across the country we have seen a major improvement in the performance of A and E departments, helped by the creation and expansion of minor injury units and walk-in centres. I am sorry that he does not feel able to welcome that.
8. Helen Jones (Warrington, North) (Lab): If she will make a statement on possible mergers of acute trusts within the Cheshire and Merseyside strategic health authority. 
The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): Cheshire and Merseyside strategic health authority is developing proposals to let NHS trusts locally apply for foundation trust status by 2008. Part of that work is looking at whether current organisational structures are best placed to meet patients' needs.
Helen Jones: It is clear from documents that some of us have seen that the SHA is working on plans for mergers, including the merger of Warrington and Whiston hospitals. Will my hon. Friend tell the SHA that that is totally unacceptable for people in my constituency, who would face a 20-mile round trip to access some services? What people want is good services provided locally. Does he accept that, because of the SHA's actions, I, my constituents and many Labour Members have no confidence any more in what is an increasingly Stalinist and out of touch health authority?
Mr. Byrne: My hon. Friend knows that I take a close interest in Warrington hospital, not least because I was born there. As my right hon. Friend the Secretary of State has said, there are no firm plans for merger proposals. However, once such plans are developed, some very simple tests will be applied to determine whether they will benefit patients living in all the communities being served, and whether they are in line with the White Paper published yesterday. Moreover, any plans will be subject to full public consultation. I know that my hon. Friend is meeting the SHA chief executive on Friday, and I hope that she will make the points that she raised earlier forcefully to him.
Paul Rowen (Rochdale)
(LD): I am sure that the Minister is aware of the reconfigurations and mergers planned in Greater Manchester, but is he also aware of the press statement issued last week by the Best for
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Health team that stated that petitions were not worth the paper on which they were written? Is that the right response for a listening health service?
Mr. Byrne: That was not an appropriate comment, given that the petition in question had 30,000 signatures. I want to put on record my thanks to those who made the effort to get involved in the campaign. The White Paper that we presented to the House yesterday contained a wide range of expectations about how local health organisations need to consult with the public in their area. We also set out a range of new ways in which local voices will be heard in the consultations. We fully expect the NHS in the hon. Gentleman's constituency to give full regard to the proposals in the future.
Mrs. Gwyneth Dunwoody (Crewe and Nantwich) (Lab): May I refute the suggestion that the SHA is Stalinist? It is not nearly that competent. Will my hon. Friend look seriously at the suggested reorganisation of the heath trust used by my constituents? It would lumber us with enormous deficits yet deliver no improvement in services, and would lead to many very incompetent administrators receiving very large redundancy payments.
Mr. Byrne: My hon. Friend speaks with great wisdom, and I am sure that the local NHS will profit from her advice. I shall make sure that the attention of the local chief executive is drawn to her comments this afternoon.
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