Mike O'Brien (North Warwickshire, Labour)

I was wondering how long it would take before I was called to speak. Andrew George put his argument fairly. Essentially, he said that the area had received a significant increase in funding, but it was not enough. I have a great deal of sympathy with his case. The Government clearly have a funding target. It will take time—I shall explain why—to reach that target.

The hon. Gentleman argued the case well. It is incumbent on the Government to ensure that we put in place the right formula and the adjustments that that requires. Both increases and, as he rightly said, decreases over time for some areas, or at least smaller increases than they might have expected, need to be phased in. As everyone knows, there is no unlimited pot of money. The Government have tripled the funding going into the NHS, and the hon. Gentleman rightly welcomed that. However, we must ensure that funding is properly managed. Very often that is done at a local level.

The funding formula needs to be reviewed from time to time. As the hon. Gentleman rightly said, the review was overdue, but it has now taken place. Part of the formula was set by the previous Conservative Government and it was enormously unfair to certain areas. We have put that right, which will result in Cornwall getting more money, as he recognised. He put his case fairly, as did Dan Rogerson.

Julia Goldsworthy indulged in a bit of party political knockabout. Somewhere in the knockabout were a few serious points, but when she got to them, they struggled to get out. One thing on which I agree with her is that it is important that we congratulate NHS staff on their dedication and hard work. They are improving the quality of services in Cornwall and across the country, and they are working hard to do so.

As medical science continues to advance, the NHS becomes capable of ever more extraordinary feats of clinical care. For some complex procedures, well-equipped and well-staffed specialist centres are more effective. There, round-the-clock consultant and specialist nurse expertise can be assured and expensive technology can be concentrated. An increasing amount of care is happening in the NHS, and much of it is out in the community in GP practices, health centres and people's homes, with more complex, specialist or emergency care concentrated in a few more specialist centres. However, Ministers or civil servants in Whitehall do not decide the organisation of local health care. It is decided by local health care professionals on the ground. Organisational changes must be based on medical grounds and what is best for local patient care.

Finance is one of the key issues. The NHS has benefited from an unprecedented growth in finance. When the Government first came to power, health spending was just £426 per head. In 2010-11, it will be £1,612. In 2009-10 and 2010-11, primary care trusts will be allocated £164 billion. That means that, on average, PCTs will receive an increase of more than 11 per cent.—actually, 11.3 per cent.—or an extra £8.6 billion. The people who are best placed to make decisions are those closest to it, and more than 80 per cent. of the entire NHS budget is now in the hands of local PCTs—a higher proportion than ever before, under any Government.

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