Primary Care Trusts

I, too, welcome the Minister to his new position. He and I have had the chance to meet across the Dispatch Box from time to time but in different roles, and it is a great pleasure to have an opportunity to debate with him today what is unquestionably of the greatest importance to all constituents in all constituencies, namely, their current and potential health care. Equally, I pay tribute to the Chairman of the Health Committee. He has presided over an important and timely contribution, which is not always easy to arrange in Select Committee affairs, to what has, in effect, been one side of the great argument on health care; that is, how much does patient care come out of structures and how much does it come out of the professional application of clinical and management approaches? The report is highly influential. Notwithstanding the fact that some time has elapsed and that one could argue that the debate has been somewhat overtaken by events, the report stands well, despite the risk that it always carried. The members of the Committee are to be congratulated on their combined efforts in producing it, and I join in congratulating the secretariat that supported its work. In an informed and sincerely articulated debate by Members across the House, we have heard powerful points about the manner of genuine consultation and commitment to it. We have heard about appropriateness and accountability and how health care services can best be configured structurally for delivery, whether according to geography or to some form of local arrangement. We have heard, notably, from the hon. Member for Wyre Forest (Dr. Taylor) about the distraction effect. The point is powerful coming from him, as somebody who has worked at the front end of the health service and no doubt knows what it is like to be on the receiving end when politicians, including Administrations of a different political hue, come up with grand designs and the professionals have to down scalpels and deal with political directions.