The Minister of State, Department of Health (Mr. John Hutton): Decisions about the configuration of A and E departments, including their closing or merging or the opening of new facilities, are a matter for local determination, taking into account local needs and clinical advice about safety and quality. The Government remain fully committed to modernising and improving A and E services throughout the NHS, which is why we have made the biggest investment in them since the NHS was established in 1948.
Mr. Wareing: I thank my right hon. Friend for that answer. One of the A and E units closed during the last decade was that at Broadgreen hospital in Liverpool, and I believe that that closure has contributed to the increasing strains on the Royal Liverpool and Fazakerley hospitals. It is necessary to review the situation in Liverpool, so I hope that my right hon. Friend will visit the city and reach the same conclusion as me: that Broadgreen A and E unit and its associated services should reopen.
Mr. Hutton: Let me make one thing absolutely clear: I live 110 miles from Hexham, so the hon. Gentleman should check his facts before making allegations of that kind in this House. The circumstances of Kidderminster and Hexham are different. At Kidderminster, we decided no longer to provide blue light services because of the advice from local clinicians about the safety of those services. Such concerns were not expressed about services at Hexham.
Andy Burnham (Leigh): Leigh lost its A and E department in the mid-1990s and people there are under no illusions about who is to blame for that. Although I accept that we cannot reopen an A and E department in Leigh, will the Minister give full consideration to the case for a new diagnostic and treatment centre at the Leigh infirmary site, using the spare capacity? It is well located, and separating acute services from elective admissions in the Wigan and Leigh trust makes good sense.
Mr. Hutton: I strongly agree with my hon. Friend. The new diagnostic and treatment centres can make a positive contribution to elective and emergency services right across the NHS. We are considering a number of proposals to establish the new centres and we shall look carefully at his suggestion. An announcement will be made in the near future.
Mr. Crispin Blunt (Reigate): Yesterday, after four and a half years of Labour Government, the East Surrey hospital A and E department had to close to 999 calls because there were 40 patients on trolleys; Crawley hospital had to do the same. That has appalling consequences for people coming in for elective surgery and appalling consequences for my constituent Philip Sprake, who could not be found a place in that hospital and had to be sent to Bromley, which is an hour away, and for his family. The trust is bankrupt, so the issue is certainly about money and resources. When will money and resources get to the trust? After four and a half years of Labour government, what is happening there is an absolute disgrace.
Mr. Hutton: I have to tell the hon. Gentleman that very much more money and resources are reaching trusts in Surrey than was ever the case under the previous Administration. [Interruption.] It is no good him shaking his head, because he knows that that is precisely the case. I accept that the situation at that A and E is serious and we are looking closely into the exact circumstances,
Charlotte Atkins (Staffordshire, Moorlands): Is my right hon. Friend aware of the excellent work of Government inspectors? They visited my local accident and emergency department in north Staffordshire recently and made 71 recommendations based on best practice. Does not that contrast with the days of the internal market when every hospital was in competition and best practice was not shared?
Mr. Hutton: I agree. Such lessons were drawn out in Professor Sir Ian Kennedy's report. We have made a significant advance not only by establishing new national standards, including a new emergency care strategy, but by spreading best practice throughout the service.
Dr. Liam Fox (Woodspring): Further to the question that my hon. Friend the Member for Reigate (Mr. Blunt) asked, I have the facts about East Surrey primary care group. It states that the accident and emergency departments in both Redhill and Crawley will be closed to all admissions from 4.45 pm until the review at lunchtime on 22 January. What would happen in the case of a major road accident or an accident at Gatwick?
The Parliamentary Under-Secretary of State for Health (Yvette Cooper): The Department plans to monitor local HIV prevention through the AIDS (Control) Act 1987 and through the NHS performance assessment framework. That will include monitoring expenditure for groups most at risk of HIV, and developing performance indicators to assess progress towards meeting the prevention target in the sexual health and HIV strategy.
Mr. Gerrard: My hon. Friend knows that some anxiety has been expressed about transferring commissioning to primary care trusts. I appreciate her comments about the Government's continuing to monitor. Will she assure us that that will continue beyond the next financial year into the following year, when primary care trusts become wholly responsible? If it is found that spending is not maintained, especially on vulnerable groups, will the Government be prepared to intervene?
Yvette Cooper: I can assure my hon. Friend that we envisage long-term arrangements for performance management on sexual health and HIV. It is right to bring that into the mainstream of the NHS, but we are not
Mr. Simon Burns (West Chelmsford): Does the Minister know about doctors' grave anxieties, especially in London, that female asylum seekers who come to this country from areas of high HIV infection are ignorant of the dangers of HIV and will not be tested? That means that those who are infected do not receive proper health care as early as possible and it places additional strains on the provision of health care by the NHS.
Yvette Cooper: It is clearly important that people with HIV/AIDS receive treatment. We are keen to increase testing and to ensure that we reduce the amount of undiagnosed HIV. The hon. Gentleman is right that that affects asylum seekers and others who have travelled abroad. We are reviewing the procedures for providing health care and testing for asylum seekers to ensure that we deal properly with any problems that arise.