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I do not know what world the hon. Gentleman is living in, but he is not living in Lincolnshire, because I remember the conversation that he and I had with the chairman of the United Lincolnshire Hospitals NHS Trust; however, I will not go further down that path.
It is not only Opposition Members who believe that it is necessary for there to be a moratorium on the service reconfigurations that are proceeding in the absence of support or evidence. The new Secretary of State for Work and Pensions, in the deputy leadership election, at least had the honesty to say that
"we need a moratorium on structural change and reorganisation in the NHS."
So we have support from within the Cabinet ranks.
I will come back to accident and emergency departments, but I wish to start with primary care, because we seek a primary care-led service. I wondered where the new Prime Minister had been in recent years when, during his leadership election, he talked about access to GP services, because the GP contract has reduced GP access. We do not know to what extent, because the Department of Health has failed to publish the patient access survey that it commissioned at great expense. But we do know that the introduction of the out-of-hours contract was a shambles, according to the Public Accounts Committee. We know that NHS Direct has shut 12 of its 50 call centres, including the one in Cambridge, which I visited, because the planned expansion of NHS Direct has been abandoned.
Walk-in centres have been cut back. The figures for early 2006, compared with 2005, recorded fewer people attending walk-in centres. Indeed, fewer people visit walk-in centres in a year than visit GP practices in just three days. We have also seen community hospitals closed, local A and E services downgraded and birth centres and local maternity units threatened with closure. Care closer to home, which was a mantra of the previous Secretary of State, is turning, in many cases, into care further away from home. Care closer to home is not happening.
I welcome to the Front Bench the new Under-Secretary of State for Health, Ann Keen, who was president of the Community and District Nursing Association. We have fewer district nurses and health visitors now, but they are the very people we most need to deliver care closer to home and reduce demand for these services. It is only really when demand for hospital services is reduced that it would be safe or appropriate to reduce the supply of services. What we have at the moment is a structure that is trying to ration demand for care by restricting supply of care, and that is no good.