To ask the Secretary of State for Health what the evidential basis is for the conclusion of her Department’s National Director for Emergency Access that an acute hospital with a catchment population of between 400,000 and 500,000 people would be better able to deliver consultant-led services, as stated in his e-mail of 27 March to Dr. Mark Signy of Worthing and Southlands Hospital NHS Trust. (138597)

There is increasing consensus among professional bodies that a critical size of hospital is required to ensure that specialist facilities are available to treat all patients with emergency needs safely. While the actual populations hospitals will serve in the future will differ slightly across the country, in general they will need to serve larger populations than is currently the case. Different clinical specialties may also have different demands in terms of the number of cases required to maintain clinical expertise.

In providing advice to any local area, I am confident that Sir George Alberti will have based his advice on ensuring and improving quality and safety of care for local people.

Ultimately, it is a matter for the local national health service to ensure the provision of urgent and emergency care services, including accident and emergency facilities, that are responsive to people’s needs. We have made it clear to the NHS that it should consider a range of factors in putting together any case for change and produce a clear business case before consultation begins.