I am delighted to have secured this Adjournment Debate. I see the future of health in Hartlepool alongside the town's economy fulfilling its potential and the putting in place of measures to eradicate crime and antisocial behaviour from our streets as the main improvements that I hope to achieve as the town's MP.

Although the debate is about the future of health services in Hartlepool, I should like to spend a few moments outlining the broad historical trends in health in the town. I am a huge believer in the concept that we do not know where we are going unless we know where we are coming from. Hartlepool suffers greatly from its legacy as a centre for heavy manufacturing industry and from decades of economic decline. Industries such as the steelworks and the docks have left their mark with diseases such as asbestosis and respiratory illness. We as a town have suffered from decades of economic decline as the traditional industries have died. Unemployment has savaged the local population, which is only now beginning to recover.

Although the past decade has brought improvements in Hartlepool's economy, we are starting our renaissance from a very low base. Car ownership, a key barometer of economic prosperity, is low—40 per cent. of households in the town do not own a car, compared to 27 per cent. nationally. That should have, as I will show, a real bearing on where health services in the town are located. Despite recent improvements, we still have to contend with the health consequences of years of economic decline, poverty and social exclusion. This legacy means that Hartlepool people suffer more ill health and disability and higher death rates from cancer, heart disease and respiratory illness, and live shorter lives than people in most other parts of the country.

The facts are stark: I received these figures only yesterday, in response to a written parliamentary question. Life expectancy for Hartlepool men is 73.4 years, against a national figure of 75.9 years, while Hartlepool women are expected to live 78.4 years, against a national average of 80.5 years. We also lead unhealthy lives. Forty per cent. of people in the town smoke, and we have more than the national average number of cases of obesity caused by poor diet and excessive drinking.

The national health service is, arguably, the Labour party's greatest creation, and it has undoubtedly improved the health of people in Hartlepool. However, it is not improving as fast as that of people in other parts of the country, and health inequalities within the town remain profound. Half the people live in wards that are in the 5 per cent. most health deprived in the country. Stranton ward is 51st out of some 8,400 wards in the country for health deprivation and disability, while Elwick ward, the most affluent ward in the town, is still in the top 3,000 for poor health.

We should also take into account demographic changes. The population of the town is ageing: the number of people aged over 75 is expected to increase by 25 per cent. in the next 15 years. That is aggravated by a sharp fall in the birth rate in Hartlepool. The number of births has dropped by almost a fifth in a decade, which has exacerbated the decline that was particularly pronounced between the late 1970s and early 1980s.

This is the challenge for those who shape the future of health services in Hartlepool: a legacy of industrial decline and associated poverty; unhealthy lifestyles; high incidence of ill health; pronounced health inequalities; an ageing population and low birth rates, all of which result in profound pressure on health resources.

Our health has not been helped by a chronic lack of investment for decades in primary health care in Hartlepool. The unwillingness or reluctance of successive Governments to invest in this crucial first call when somebody is ill or in the prevention of illness has led to an undeveloped primary care sector, which has to contend with the most difficult problems. The possibility of attracting more money elsewhere, and the generally poor quality of surgery buildings has meant that we suffer from an acute shortage of general practitioners. Hartlepool is in the bottom 10 areas of the country for numbers of GPs—we need about 12 more to reach the national average, and a similar increase in the number of community nurses. Meanwhile, GPs' average list size is 2,100, the highest in any PCT area in County Durham and the Tees valley.

The problem exacerbates itself. High patient numbers lead to extra work and more stress for GPs, which accelerates their wish to retire early or to leave the town. An estate audit in the town found that five of the 17 GP premises in Hartlepool are in poor condition, with only six meeting the criterion for satisfactory. There is an acute shortage of space in those surgeries, and that hinders their development and potential to offer a wider range of services. Most do not comply with the requirements of the Disability Discrimination Act 1995.

The acute shortage of community doctors over the years has led to an over-reliance on the local hospital. Hospitalisation rates far exceed the national average, and the hospital's accident and emergency service is stretched to its very limits as people use accident and emergency because they cannot get access to a local GP or community nurse. The number of accident and emergency attendances at Hartlepool hospital has increased by more than 9 per cent. in the past year alone.

I have painted a dark picture, and I am not exaggerating. However, amid the gloom, there is real success. This Government have recognised the health problems caused by deprivation and invested heavily in the NHS. Funding year on year in cash terms for the NHS in Hartlepool since 1997 has been close to 10 per cent. The Government's commitment to providing health services as locally as possible strengthens the case that primary care in Hartlepool needs to be developed.

Despite the massive resources invested in our health service by this Government, there is a strong case to say that we in Hartlepool remain underfunded. The primary care trust has a shortfall of some £2 million a year from its targeted allocation; the NHS trust has a projected deficit of some £6.5 million to overcome. I am grateful to this Government, and sincerely believe that no other Administration would have invested so heavily. However, I am in Parliament to stand up for the people of Hartlepool, and I believe that the Government need to provide substantial additional funding to both primary and acute care to tackle the decades of neglect in Hartlepool. Health professionals would not squander this money; there has been real success in recent years, as I shall mention shortly. Just think what could be achieved with appropriate funding.

Foremost among the successes are the achievements of the local hospital. For the third year in succession, the North Tees and Hartlepool NHS Trust has been given a three-star rating. That means that over a long period, it has consistently been one of the best performing trusts. Only 12 trusts in the country have received that accolade for three years.

The University hospital of Hartlepool has been named among the top 40 hospitals in the country, and its clean-hospitals policy has meant that, unlike hospitals in other parts of the country, it does not suffer from accusations of being unclean or of suffering from germs. In fact, it is among the top 10 cleanest hospitals in the country. The "general", as it is known locally, is genuinely thought of with pride and affection in the town.

I know from personal experience what a marvellous asset it is. All my four children were born there. My eldest son's life was saved there when he was treated quickly for meningitis, and my youngest—only two months old at the time—was admitted last Boxing day, suffering from pneumonia and bronchiolitis. All that success is due to the tremendous commitment of staff of all grades at the hospital, which is ably led by Bryan Hanson, the trust's chairman. Their loyalty and commitment to health care for the town is arguably unchallenged throughout the entire country. That is why I think it understandable that the proposals led by the strategic health authority to downgrade or close the hospital have led to concern and alarm in the town.

A dedicated campaign to save the hospital has been organised by John Bloom. John stood against me in the By-election, and I disagree with many of his policies. However, I do not doubt his sincerity and integrity on this matter. He, and others such as Peter Wolfe, have put this issue on the agenda and have not hijacked it, as others did, for short-term political gain.

Let me make my position absolutely clear: I am adamantly opposed to the closure or downgrading of the hospital. In my vision for future health care for Hartlepool, I see the hospital as the major site for acute services between Sunderland and Middlesbrough. I see the hospital going from strength to strength and improving its capacity to provide all the services it provides today such as accident and emergency services, general medicine, surgery and neurology, orthopaedics, rheumatology, obstetrics, gynaecology and paediatrics.

I have been greatly reassured by comments from the Secretary of State for Health and the Prime Minister that the hospital will be improved, not downgraded, and I see Professor Sir Ara Darzi's review as an opportunity to ensure that Hartlepool can realise its potential as a major health hub between the River Wear and the River Tees.

I do not believe that the co-location of the Hartlepool and North Tees hospitals on to a greenfield site between the two towns will be conducive to effective health care. That would go against the Government's policy of ensuring that health care should be as local as possible, and would hinder the effective recovery of patients.

As I mentioned earlier, my son Billy was ill during Christmas, and my wife and I took turns to stay with him. He was visited by his grandparents and by other relatives. We are fortunate that we have a car. Further anguish could have been caused to us, over and above the fact that our two-month-old son was seriously ill, had we relied on public transport to an out-of-town hospital over Christmas, while ensuring that our other three children were being appropriately cared for. As I said earlier, car ownership is low in Hartlepool. The ease with which family and friends can visit has an important bearing on the recovery of a patient. That ease can be achieved only by having the hospital firmly secured in the town.

It is madness that where a town has an underdeveloped and relatively under-resourced primary care sector and a subsequent over-reliance on the three-star acute hospital, some senior bureaucrats wish to remove or to limit what the hospital does, against the wishes of the people. That is akin to a person having one healthy, muscular leg and the other one in plaster, and opting to amputate the healthy leg before the other one has healed—the person would soon fall over.

That is not so say that I want the hospital, and everything that it does to be preserved in aspic—never to change. Clinical improvements mean that procedures that previously required a major operation and recuperation in hospital for many weeks can be done as day surgery. Developments such as triage in accident and emergency treatment have meant that more people are seen more quickly and with suitable prioritisation. I want that trend to continue, so that fewer people stay in hospital and that they do so for shorter periods and recuperate in the familiar, comfortable surroundings of their homes. That will mean that a faster turnover of patients can take place at the hospital, which will help to produce shorter waiting lists and greater capacity for acute care.

I also want to mention the successes of Hartlepool primary care trust, because its objectives are a major vehicle with which to achieve my vision for health care in the future. It was formed only in 2001 and had initial managerial difficulties, but it has come a long way in a short period to reverse the lack of investment in primary care over the decades. The chairman, Professor Gerald Wistow, and the chief executive, Angela Hawkes, are putting in place the vision where people are treated as locally as possible, ill health is tackled and, as far as is possible, prevented, and state-of-the-art health buildings are located in all our estates and neighbourhoods.

The success of the PCT in a few years of existence is astonishing. In terms of smoking cessation, Hartlepool PCT's clinics have helped to produce a doubling in the number of successful quitters. Thanks to the PCT and its work in implementing its teenage pregnancy strategy, Hartlepool has enjoyed the biggest decrease in the under-18s conception rate in the north-east. Work is progressing to bring more GPs to the town, often from the international doctor market. Crucially, the PCT is investing, through the development of local improvement finance trust schemes, in new medical buildings in the heart of our estates in Owton, Rossmere, the town centre and on the headland.

Those schemes are the foundation of the future of health in Hartlepool: 21st century neighbourhood health centres on each estate providing high-quality primary care and health advice to the local population, undertaking minor surgical procedures and being the first point of call for urgent cases, thereby relieving the pressure on the local hospital. For example, people in Owton go to their neighbourhood health centre for treatment rather than the accident and emergency department of the local hospital.

I am a passionate believer in the Government's policy of ensuring that health care is as local as possible. Given our historical health legacy, the PCT, in conjunction with the local strategic partnership, which I chair, understands Hartlepool's needs and is able to commission services to meet them. That is why I find it odd, and somewhat against Government thinking, that the local strategic health authority is pushing PCTs in its area to commit quickly to strategic commissioning, where commissioning for all Tees valley PCTs will be pooled under a Middlesbrough PCT. I am all for making savings and efficiencies through joint procurement of services, but there is a massive difference between procurement and commissioning. I cannot understand what possible benefit the people of Hartlepool will receive from allowing decisions about their health to be taken in Middlesbrough as opposed to in their own town.

One of the true success stories in Hartlepool in recent years has been the ability of different organisations to put aside institutional jealousy and place the needs of Hartlepool residents first. We are lucky in that the geographical boundaries of the PCT are coterminous with those of the local authority. More important is the desire to work together to improve the town's health. Joint commissioning has taken place, with joint appointments such as that of Peter Price as director of public health. Pooled budgets between the council and the PCT are already in place and, from next April, those organisations will jointly commission children's and older people's services.

That is the future of health care in Hartlepool: teams of doctors, nurses, social workers and home carers from a variety of agencies sharing information and using the same systems and procedures to tailor health care to residents' individual needs and requirements.It seems a shame that years of painful negotiation and hard work to secure partnership by those local agencies could be threatened by a blunt diktat issued on Christmas eve by the strategic health authority.

I want the partnering approach to be extended throughout the health network in Hartlepool. I want Housing Hartlepool to be part of that network to ensure that housing does not contribute to health problems. I want schools to teach children the benefits of healthy eating and I want supermarkets in the town to play a role in promoting fruit and vegetables and the benefits of a balanced diet.

In this demanding age, a one-size-fits-all approach is wrong, particularly for health care. The agencies in the town need suitable flexibility, and shared systems and procedures, to enable them to offer a personalised service as close to the home of the person concerned as possible, with the minimum of duplication from organisation to organisation.

The future of health services in Hartlepool is the realisation of our town's vision of care; it is services that are as local as possible, with an emphasis on a service to patients based on their individual needs; it is a multi-agency approach with a massively sophisticated health network; it is an adequately funded primary care sector, in conjunction with a responsive and fully funded acute sector, which allows community based health to be at the centre of the health service in Hartlepool while freeing the acute trust to undertake its valuable role. Only by realising that vision will we truly reverse decades of ill health in Hartlepool.