My Lords, I am glad to respond to the right reverend Prelate and to his particularly interesting questions about Birmingham. I am pleased to be able to inform him that part of the announcement made yesterday about 18 new hospitals related to the new ambulatory care centre at Birmingham City Hospital. As he will know, that is the outcome of a recommendation of the independent review body of which he served as an excellent member. I am afraid that I do not have in my back pocket a new hospital for the university trust. However, I can assure the right reverend Prelate that we shall make announcements in relation to the conclusions of the consultation process as soon as we can.
I agree with the point that he made in relation to tackling waiting times and waiting lists. In parts of the health system the process from GP to secondary referral to tertiary referral has been examined and a dramatic reduction in waiting times and lists has been achieved. We also know, for example, of orthopaedic departments in certain hospitals where the consultants are prepared to let go and allow physiotherapists and OTs to take on more work. Again, in such cases drastic reductions in waiting times and lists have been achieved.
We face the tremendous challenge of encouraging the whole NHS to take on those new ideas and to engage in good practices. Overall, I believe that the combination of extra resources, the concept of earned autonomy whereby people who are doing well in bringing about change are rewarded, and our ability to intervene in places that are not doing so well will be the best approach in achieving the type of change that the right reverend Prelate desires.