NHS Services (Hertfordshire)

That is absolutely the point that I would re-emphasise, as similar problems are faced in many areas. In my neck of the woods, where two hospitals are owned by the same trust, the road is an issue and travel is the one thing that is most ignored. I was not surprised to find, on looking into the matter, that the offer that was originally made in the 2003 consultation has been further downgraded. At one stage there was talk of having a birthing unit in Hemel Hempstead and using it to spread good practice elsewhere, but I understand that that is now unlikely to happen. As the hon. Member for Hemel Hempstead (Mike Penning) said, the best that will happen is that an ISTC will emerge. That is a common pattern in different places, with the same meaningless consultation forming a backdrop. Scrutiny and review sections of councils debate things, but the financial position continues to deteriorate. We can anticipate the Government’s response, which is also fairly familiar. In most such debates, the Government will say that people ought not to be wedded to bricks and mortar, that services can be delivered in the community and—to a lesser extent—in secondary care, that institutions have to co-operate, that clinical networks have to be delivered and that people will travel for the best possible service. However, that aspect of Government policy does not hang together with something that was cited several times in the consultation, which is the Government’s own policy of keeping the NHS local, which produced a well-known pamphlet that is much cited but rarely acted upon. That policy recognises that although people are ready to travel for specialist care, they expect to find many services locally, particularly A and E services and those that look after people with chronic conditions that involve repeated journeys to hospital. Additional travel in such cases means extra trauma. Someone who has to go further to an A and E department might not arrive with a long-lasting problem or even with a major trauma, but for someone travelling with a child to A and E who is not sure what is wrong, every extra mile is a very unpleasant experience. People do not mind clinical networks, if that is what the Government want, but they want the clinical networks that suit them and their clinical needs. As it is, reconfiguration across the piece normally results in health authorities presenting a menu, a rather bogus form of consultation taking place and, when it is completed, people often choosing to go in unexpected directions, rather than to the hospitals to which they were expected to travel in the first place. As many hon. Members have said, the backdrop is often the need for a quick financial fix, which discredits any reconfiguration proposal whatever.