Primary Care Trusts

I am sure that all hon. Members agree that debates such as this are valuable occasions. We owe a debt of gratitude to the Chairman of the Select Committee, the right hon. Member for Rother Valley (Mr. Barron), and its members, some of whom are with us this afternoon, for a valuable and hard-hitting report. This morning, I refreshed my memory by rereading sections of the report and was struck by the forthright language in which it was couched, to which the right hon. Gentleman referred, which conveys a lot of the anger that was felt at the time. The letter appeared and although there was some precedent, it still felt like a bolt from the blue and was much firmer than anyone expected. It came at came at precisely the wrong time in the parliamentary cycle and at the wrong time for any meaningful consultation to take place. Although things have moved on, it remains an important document and our debate this afternoon has highlighted some of the issues that need to be considered as we go forward. Something that strikes me from what I have heard from colleagues around the country is how different everyone’s local case is. My perspective is coloured by coming from an area with a relatively small unitary authority. In our case, to argue for coterminosity was also to argue for localism, and we got it, albeit not under the original proposals. Other hon. Members have referred to wanting a PCT that understands local issues and is coterminous with the social services authority. I was arguing for the same things, but I fully appreciate—the debate has helped me to understand the point—that for some colleagues those two things were in tension. That leads me to the first key point arising from the debate. It could not be more apparent from the debate that such decisions must be local decisions. I was interested in the comments of the hon. Member for Staffordshire, Moorlands (Charlotte Atkins), who said that she is a great advocate of local decision making, but then implied that because there may be conflicts within an area, there should be some sort of external, independent arbitration. With all due respect, that seems to be entirely misconceived. Local government exists for that purpose—to reconcile the competing claims of different sub-parts of an area. We do not say that just because a county has one bit that wants one thing and another bit that wants another, we need an independent third body to tell it what to do. We resolve the matter through open, local, democratic procedures in the local area.