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As always, my right hon. Friend anticipates what I am about to say and says it in a far more straightforward way. He is absolutely right to say that there will be exceptional circumstances; there has been one instance so far. In such circumstances, the health economy in a particular area will need to be looked at—not in isolation; that is impossible owing to the nature of patient flows and the delivery of care—in order to get to the bottom of the problem and solve it on the ground.
A number of hon. Members said that clause 119 was a vehicle for closing down hospitals or services while totally disregarding the wishes and needs of the local health economy and local people. I say to them with the greatest respect that they have—probably for genuine reasons—misunderstood the purpose of the TSA. I ask them to think again, because this is too important an issue to be politicised and used in a game of ping-pong between political parties, or groups within those parties, to try to score political points. Our sole aim must be to ensure the improvement and viability of services. Sometimes, tough decisions will have to be taken—because of changing patterns, or whatever—and in the overwhelming majority of cases, they will be taken through consultation and through the decision-making process in the local health economy.
We have been talking about the power of the TSA. I must point out, in the friendliest and gentlest way, that that power was not introduced into the health service by this Government. It was done, I think I am right in saying, by the right hon. Member for Leigh’s predecessor, and he did it for very good reasons. He accepted, as my right hon. Friend Mr Dorrell, the Chair of the Select Committee, said in his intervention, that there will be rare occasions when everything else has failed and this measure of last resort must be used. It is viable and reasonable to have that power as a measure of last resort, as the previous Government obviously thought; otherwise, they would never have put it on the statute book in their legislation.