Health Services (Gloucestershire)

I understand that it is in terms of income and expenditure, but there is also the issue around the outstanding deficits that organisations have. Those have to be dealt with too. Part of the top-slicing that is happening in those parts of the health sector or health trust that are in balance is to try to ensure that there is, if you like, shared responsibility for maintaining health across communities, to follow up on the point that my hon. Friend the Member for Stroud made about what is being asked of different parts of the health service in his strategic health authority area to deal with particular problems and issues. That still requires an openness to debate some issues that involve some hard decisions and hard choices about the services that are necessary for the future. It raises issues around engaging the public. Importantly, as I said earlier, it involves having a discussion about what sort of services people want but also, in order to get those services, what is necessary. It is undoubtedly the case that, with the best will in the world, for some of our most advanced services to get the personnel to provide the best techniques in certain areas of health in our hospitals, some consolidation is necessary. It is also clear that, particularly in respect of older people, we have to address some legacy issues of community hospitals, which were created with the best intentions, and to consider whether they can meet the needs of the future. I raise another issue in relation to health staff. Talking to a nurse the other week, I found that one of the problems has been that, in some of our community hospitals—as I say, I do not know enough about all the individual community hospitals in hon. Members’ areas—the sort of service that they are offering, which is at its best a holding bed for older people, is not providing training and other opportunities for staff who want to work in this sector, particularly those who want to work closer to where people live in the community, providing a 24/7 district nurse service, for example, for people who most of the time do not need to go into hospital. They could get the services they need at home, with little disturbance to their life and none of the problems about relatives having to try to visit them and all those other things. We have had an interesting debate. I hope that we have explored, possibly in a wider way, some of the challenges that face the health service. It is about value for money but importantly it is also about dealing with a problem which has been happening for many years in respect of the way in which health has been funded. It is also about dealing with perhaps some decisions that should have been made earlier about the sort of health service we want, which as I said is about prevention and support as well as treatment. However, to get to the place where we can have that discussion and start thinking about a 21st-century health service, undoubtedly, these problems have to be resolved financially but also in terms of the organisation of services. Question put and agreed to.