NHS Reorganisation

My hon. Friend is right. I said at the time that it was nonsense to create three PCTs in the area of north Cumbria, which used to be Cumberland, for its population of 350,000, but that was what happened. One of the PCTs covered fewer than 70,000 people. All the other north Cumbria Members disagreed with me, as did all the district councils and the county council, but in 18 months, instead of having three management teams, it was decided that there would be one management team and three trusts. We thus have the nonsense at the moment of having three chairs of trusts—one for west Cumbria, one for Carlisle and one for Eden—and those trusts’ non-executive members, but one management team. It cost millions of pounds to make the change, but it caused tremendous confusion about which PCT was responsible for which service because, for example, Carlisle and District PCT could end up being responsible for services in west Cumbria. That is why I support the reorganisation. Cumbria and Lancashire strategic health authority has come up with a solution, but unfortunately it is not the easy one, which would be to keep Morecambe Bay PCT, which is working well and covers the south of the county and part of Lancashire, and create one PCT for north Cumbria. Instead, it has decided to use the county boundaries and go for a county-wide PCT. I accept from Conservative Members that that is basically what the Government want, rather than a reasonable rationale. Anyone who knows Cumbria will realise that it is vast. Its two centres of population are my constituency of Carlisle and Barrow-in-Furness. Those places are 90 miles apart and have little to do with each other, yet it is suggested that we create one PCT for the area. However, everyone knows that two-tier local government is to be reformed, so we could end up in three years—this is a 50:50 bet—having created a PCT for Cumbria that is not conterminous with the new local government boundaries, which would not make any sense. The Home Secretary announced yesterday that Cumbria is not really that important because its police service will be in with that of Lancashire—I do not have major worries about that. The ambulance service will be merged, too. I have been to see the chair of my local ambulance trust and the chair of the control. They are not concerned because they believe that being part of a big consortium will create greater buying power, so the service will be able to get the equipment that it has been lacking under the present scheme and thus be brought up to the standard that exists in the rest of the north-west. I do not buy the idea that there is an issue about mergers. If it was left to some hon. Members, we would still have the old county borough of Carlisle ambulance station. We have to think about saving money. We need a PCT in the north of Cumbria and the one at Morecambe bay. We also need—this was mentioned by my hon. Friend the Member for North Swindon (Mr. Wills), who is no longer in his place—to take that process further. The acute trust should manage the community services and, eventually, the social services. We should have a care trust in the north of the county. That works well, as a pilot scheme in Northumberland has shown. We will end up with another unsatisfactory situation, and we will reorganise again. We do not want any more reorganisation. It is not necessary; it costs money and on many an occasion it has cost us talented people. The right hon. Member for Suffolk, Coastal mentioned the problem of rural areas. In north Cumbria, the population determines that we have one district general hospital, but because of the geography, that population is split between Carlisle and the west coast, so we need two. We find it very difficult to manage with the moneys that are available. Governments of both parties have ignored that. There used to be a thing called the RAWP, or resource allocation working party, formula—only two people understood it, and one of them was mad—and that never gave us adequate money. We welcome the extra resources from the Government, but I feel, and I may be alone among north Cumbria’s MPs, that they have got it wrong. I felt that last time, and I was right then.