The long-term future of the Guy's and Lewisham national health service trust will ultimately be determined by the willingness of districts and GP's to send patients there.
I am confident that the managers and clinicians at Guy's and Lewisham will continue to ensure that high-quality, cost-effective patient care is provided to meet the needs both of local people and of patients from further afield.
Will the Secretary of State guarantee that no two-tier service will develop in Lewisham? Is he aware that the two fund-holding general practitioners from Bromley have applied to the trust for a contract that not only asks for accelerated waiting times but demands that all their patients are seen by locum consultants and senior registrars? Will he instruct the trust not to accept that contract, or does he believe that my constituents deserve a second-rate service?
I should have thought that the hon. Lady might welcome the new and better services that many of her constituents are receiving and would turn to the districts and say that they should match that performance in their contracts. It is a pity that she did not mention, for example, the new children's unit that is to be opened at Lewisham hospital this week to replace the 119-year-old unit at Sydenham hospital—perhaps she will be at its opening.
Does my right hon. Friend agree that it is dangerous, cynical, electioneering nonsense to talk about a two-tier system? Will my right hon. Friend make it 100 per cent. and unequivocally clear that the health service trusts are not opting out of the health service and are beholden not to big business, property developers or shareholders but to the best possible care of patients?
Will the Secretary of State answer the question of my right hon. Friend the Member for Lewisham, Deptford (Ms. Ruddock)? Will there be queue-jumping at Guy's and Lewisham, which will mean that, instead of patients being treated according to clinical need, some patients will have to wait longer and be treated by more junior members of staff because a minority will be able to jump the queue? Is that the system that we shall see at Guy's and Lewisham?
The hon. Lady is confused. It is for Guy's and Lewisham, as a hospital trust, to set its proper priorities for clinical care. Those who are seeking better treatment for patients, whether they are districts or GP fund holders, are doing their best for their patients and should be encouraged to do so.