Mr. Jeremy Hunt (South-West Surrey) (Con): We have had a good deal of discussion today about how the reconfiguration of acute services will lead to improved clinical outcomes, but the vast majority of Members who are fighting to protect services in their constituencies—Conservative or Labour, Back-Bench or Front-Bench, even members of the Cabinet—will say that it is a question not of clinical outcomes but of financial deficits. This is about savings, not services.I want to illustrate to the House why that is the case with reference to the Royal Surrey county hospital, which serves many of my constituents. Although I shall talk about one hospital in specific terms, I want to stress that all Surrey MPs are united in opposition to cuts or reductions in services to any of our constituents. We are four-square together on that.The Royal Surrey county hospital has the lowest mortality rate in the country, and it sees 99.5 per cent. of its A and E admissions within four hours, as against a national target of 98 per cent. and a national average of 98.5 per cent. The Secretary of State spoke earlier about the critical importance of A and E departments managing their admissions so that as many patients as possible were seen locally and seen at hospitals only when necessary. On that indicator, which is known as managing variety in A and E admissions, the Royal Surrey county hospital comes top in the country out of 303 trusts. It is in financial balance and was rated as good by the Healthcare Commission. It even received a £100,000 prize awarded by the Minister of State, Department of Health, the right hon. Member for Doncaster, Central (Ms Winterton), for real, significant and sustained improvement in performance. Mr. Humfrey Malins (Woking) (Con): Will my hon. Friend give way?Mr. Hunt: I am delighted to give way to my hon. Friend, who has given strong support to the campaign both for the Royal Surrey county hospital and for St. Peter’s hospital, Chertsey.Mr. Malins: I am most grateful to my hon. Friend, who is rightly speaking so favourably about the Royal Surrey county hospital. He will know that it serves many of my constituents in the Pirbright and Normandy area, who regard it as a vital asset. I support everything that he is saying and thank him for saying it. He will know that St. Peter’s hospital is another very important Surrey hospital, and the point about Surrey MPs being united is a very good one.Mr. Hunt: I am grateful to my hon. Friend for his excellent intervention. A good illustration of precisely the point that he is making was given in the earlier discussion about primary angioplasty—this important new specialist service that will apparently be made available by the reconfiguration of acute services. All three hospitals whose A and E departments are under threat of being closed or downgraded—Frimley Park, St. Peter’s in Chertsey and the Royal Surrey county—offer primary angioplasty, so the result of closing any of those departments will be to restrict, not increase, access to that vital service.Why is it that we are talking about the closure of such a vital hospital, despite the incredibly impressive performance that it has shown? The average time that it takes my constituents to get through the doors of an A and E department after an accident or emergency is currently 52 minutes. That is dangerously close to what doctors call the golden hour—that vital 60 minutes in which it is vital to get people through the doors of an A and E department if their chances of a good outcome are to be maximised. That is important, for example, if they need a computerised tomography scan to identify whether they have a stroke or a heart attack, with the very different treatments that will result according to the diagnosis that is made. If the Royal Surrey county hospital loses its A and E department, the average time that it will take my constituents to get through the doors of an A and E department will increase from 52 minutes to 65 minutes. That means that more of my constituents will not get through the door of an A and E department within the golden hour than will do so.According to consultants, the result is that 2,000 additional people from my constituency who are in need of resuscitation—the most acute form of emergency, involving people who have effectively stopped breathing—will not get into an A and E department within an hour. Consultants are quite open about the impact; they are saying that people will die.Despite my anger with what the Government are doing, I am not suggesting that they have deliberately set out on a course of action that will cost the lives of my constituents, but that is precisely what will happen unless they are prepared to do three things. First, they need to tear up all the consultants’ reports that they keep using as the basis of the reconfigurations, because although they are often excellent in theory, they bear no relation to what happens on the ground. I remind Ministers that it was reputedly a consultants’ report that advised Railtrack to stop its ongoing programme of track maintenance in favour of a much cheaper policy of merely repairing tracks as and when they broke—a policy that directly led to a series of appalling train crashes and, in the end, to the demise of Railtrack. This is the first day of Lent, so here is an idea for a Lenten resolution for Ministers: they should stop using consultants’ reports to see whether they can wean themselves off the habit.Secondly, Ministers should go out and look at what is happening on the ground. It is no good their hiding behind the fiction that these are local decisions made by local people on the basis of local circumstances—they are made on the basis of a policy framework decided by Ministers and a financial framework set by the Government. True leadership involves getting stuck into the detail so that Ministers really understand what is happening.Finally, Ministers need to start to think about the root cause of these problems—namely, fundamental flaws in the funding formula, which massively underweights age as a factor relative to social deprivation. Of course, socially deprived areas have additional needs in terms of health care, but the current weighting is very skewed against age. My constituency has a lot of older people, and as a result our funding allocation is increased by 2 per cent., but the lack of social deprivation means that it is reduced by 25 per cent. That cannot be right when all the evidence shows that the biggest determinant of demand for health care services is age, not social deprivation.Anne Milton: Will my hon. Friend give way?Mr. Hunt: I am delighted to give way to my hon. Friend, who is so committed to the campaign for Royal Surrey county hospital that she stayed out in the cold in Parliament square one night in December to protest against the closure plans.Anne Milton: It was a very pleasurable evening in the company of my hon. Friend.The Minister, who has been shaking his head, would find many people throughout the country who agree with every word that my hon. Friend has said. Age is the strongest indicator of morbidity, and he needs to divorce himself from the belief that deprived areas need health care services—what they need is money for public health.Mr. Hunt: As ever, my hon. Friend makes an excellent and important point, which is backed up by strong evidence produced by Professor Sheena Asthana of the university of Plymouth who has studied the areas with deficits and identified a strong correlation between deficits and semi-rural areas with large older populations. It is not true to say that deficits are the result of poor financial management, because that is as likely to happen in an urban area as in a rural or semi-rural area.If Ministers decide to proceed blindly on, ignoring all the concerns expressed with the greatest sincerity by Members in all parts of the House, the anger in the country will make the poll tax riots look like a vicar’s tea party. I could be cynical and say that the lack of marginal Labour seats in Surrey makes it unlikely that Ministers will show any interest in coming to Surrey to see what is happening there. We have invited them countless times, and every time they have refused to come. I would rather appeal to their better natures by saying this: the NHS was founded to help older people, poorer people and vulnerable people, and if they proceed blindly on with the plans, those are the people who will suffer as a result. For all their sakes—for the sakes of the people in South-West Surrey, Guildford, Woking and Surrey Heath—they should stop before it is too late and the lives of ordinary people are lost.