The NHS is changing because medicine and treatments are changing. If we do not keep up with the times, services will not keep on improving. Local services are changing for the benefit of patients, and that is what the NHS is there to ensure. That may mean changes to how surgery is delivered, who is admitted to hospital, and how effective community care is. There are so many issues involved in reconfiguration, which can make a huge improvement to patient care.
Will the Minister give an assurance to my constituents, 9,000 of whom have signed a petition on the subject, that reconfiguration will not mean the closure of the Peter Bruff ward in Clacton and District hospital?
What is important to local people is the consultation. I am aware that the hon. Gentleman was involved in that and has met representatives from his primary care trust to discuss the issue. That is what I encourage him to do, because that is what he believes in. He believes in local accountability, and that is what he has in his constituency. As a founder member of the Cornerstone group, surely he agrees with removing decision making from Whitehall and making it into local accountability.
In order to maximise the effectiveness of the health service, we have to ensure that we use to the full the considerable talents available to us in the NHS staff base. Has my hon. Friend yet had a chance to look at the all-party pharmacy group report on the future of pharmacy, and has she been able to make an assessment of how pharmacists could take the pressure off general practitioners and accident and emergency departments to improve effectiveness and efficiency in the health service?
I thank my hon. Friend for that question. Of course the skills mix in the health service is crucial to the changes that we can make to patient care. The advancements that pharmacists have brought about for us by operating out of health centres in larger supermarkets, and by being there to advise on many health issues, has generally improved the health of patients. As my hon. Friend said, the skills mix is crucial to future work force planning and the delivery of care for NHS patients.
Last week, the Worthing Herald reported that Worthing’s accident and emergency department had 1,258 admissions. That equates to 65,500 people visiting every year. Under reconfiguration proposals—not scare stories—the PCT proposes to close that accident and emergency department, and it expects people to join the car park that is the A27 and go to either Chichester or Brighton. How many of those people does the Minister believe are timewasters who do not actually need an accident and emergency department in the hospital of the largest town in Sussex?
The hon. Gentleman raises an important issue on accident and emergency services, but how could I possibly know who was attending the accident and emergency department without looking at the figures? I would expect the local management and the local PCT to do that, and I would expect the local MP to conduct a responsible consultation to ensure that patient care is delivered appropriately in the accident and emergency department. That is why reconfiguration of the health service can be good for patients, as I am sure he would agree.
As NHS configuration depends not just on clinical judgments and local opinion but on the financial consequences of the tariff system, does the Department have any proposals to review the tariff regime, which almost certainly undervalues accident and emergency work relative to specialist surgery?
All areas are for review, all areas are being consulted on and everything must be looked at to make sure that we are delivering good, effective patient care.