Health Bill [HL]

As my noble friend Lord Carlile has put his name to the amendment, perhaps I might make just one or two brief comments. Nobody ever accused the noble Lord, Lord Tebbit, of not having backbone and of coming away uninjured; we do not realise quite how tough his backbone is. I take three key points from the debate. First, as the noble Earl, Lord Howe, said, the services which we have are the result of historical accident and great charitable effort—I have no wish to denigrate that at all—but I am not sure that those services would now be deemed to be the best if we were to start from scratch. Secondly, the noble Earl, Lord Howe, was right that we are in urgent need of data on incidence, frequency and, most of all, location. Let us be absolutely honest: we shall not have a specialist unit in every district general hospital; there will always need to be a small number of highly specialised units which filter out their knowledge and expertise into secondary and primary care. The question is where they should be. The location of our current services is an accident. I do not know, and I would like somebody to tell me, whether there is a case for a new unit in Birmingham, because the new military hospital is there, which I imagine is seeing an awful lot of people with spinal injuries and is perhaps developing an area of expertise. Particular sports might attract a unit. For example, I imagine that if you were going to choose a location for a national centre in Scotland, you would want to find a location that was not only within a short distance of the largest centre of population but also within reach of people who have climbing accidents, who have a high number of spinal injuries. Thirdly, the noble Lord, Lord Walton of Detchant, was leading us to the right point on the collocation of those services with others. In this day and age, with research as it is, there is an increasingly convincing case for having spinal injury and neurological units, if not together, then in close proximity. I do not wish to take the Committee into territory that might be contentious, but some of the research—for example, on stem cells—is going on in neurology and will have applications to those with spinal injuries. When the Minister comes to respond to the debate, she may feel that her department is unable to accept the amendment. However, perhaps she can take those points from this debate and indicate whether and how the department would be willing to review and update the overall provision of these badly needed services.