It is with pleasure that I respond to my hon. Friend's debate and congratulate him on securing it; I know that the subject is a matter of huge importance to him and his constituents.

I want to say a few words in response to his remarks about public health. Although I shall not say a lot on those topics, because I need to focus on the specific issues that my hon. Friend raised about hospitals and primary care trusts, that should not suggest—and I can tell that this goes for him too—that we give a low priority to public health, prevention and the Government agenda, which makes health care, and health itself, a top priority.

I concur with my hon. Friend's remarks about the importance of tackling health inequalities and obesity, and about the need to avoid over-reliance on hospital services by securing good services in a community setting. I am, in addition, pleased to congratulate the PCT and others involved on the drop in smoking brought about through the quitting smoking services, as well as on the teenage pregnancy figures that he mentioned. All those things are terribly important and we need to tackle them if we are to crack the issue of health care and health in the longer term.

To deal with some of the more specific issues, Hartlepool PCT, as my hon. Friend acknowledged, has received large allocations of £93.6 million in 2003–04, £102.5 million in 2004–05 and £112 million in 2005–06. Those amount to a cash increase of £26 million, or 30 per cent., over three years. That compares closely to the overall national average. It is slightly less, but by only a small amount—the figure is 30.27 per cent. compared to the national figure of 30.83 per cent.

The next round of allocations will be announced imminently, and I am sure that my hon. Friend will take a keen interest in that. That is in the context of record increases throughout the country, which means that there has been a big cash injection to enable many of the issues that he raised to be addressed.

I turn to the Tees service review and then the work of the PCT. To respond to my hon. Friend's point about where decisions are made, at the end of the day 75 per cent. or more of the money is received by the PCT. It is up to the PCT to commission locally the services that it feels are most appropriate for the people of Hartlepool. In that setting, responsibility has also been given to the strategic health authorities for running the NHS and running health in their areas, alongside the PCTs. In that context, my hon. Friend will remember the remarks that my right hon. Friend the Secretary of State for Health made last summer:

"Hartlepool will still have a full and proper hospital service after the review has taken place."—[Hansard, 8 June 2004; Vol. 422, c. 312.]

I should like to assure my hon. Friend that there is no going back on that commitment.

In looking at how the services are developed for the future, the Department and all the strategic health authorities have a responsibility to ensure that the NHS not only provides high-quality care today, but will be able to provide it in 10 years' time. The service is not static; developments occur all the time, and possibilities for new treatments and new ways of doing things evolve, which is to the benefit of patients. We must ensure that our health service generally, and in Hartlepool specifically, continues to evolve in such a way that, as patients, we all get the best service possible.

The current review of services in the area north of the Tees is designed to ensure that. There are three elements to any possible change. First, primary care is the key to the future of the NHS, as I said. It is now possible to provide a wider range of care, including minor surgery, X-ray and other tests. I note my hon. Friend's remarks about high-quality facilities in all the communities around Hartlepool and the importance of providing services away from acute hospitals, which I have seen elsewhere and which are more convenient and often much more effective in a community setting.

The reason for the change is that providing services in primary care makes services more local for local people, who will be able to receive treatment and care in local surgeries and other facilities close to their homes. There are a number of benefits to that. I note my hon. Friend's remarks about car ownership levels and the importance of travelling. The changes can mean a lot less travelling and less pressure on the hospitals, and therefore shorter waiting times for those who genuinely need a hospital service that cannot be provided in a community setting. In line with recent announcements, it is also important that the care of those with long-term conditions be managed closer to home too. There will be better prevention of ill health by targeting people at risk, which is an aspiration that he and I share.

The second element is the need for all emergency services to work together more effectively. At present, there is often confusion about the best thing to do. People end up in an accident and emergency department just because they know that it is there and that it is open, but it may not be the best place for them in all circumstances. The right service may be advice from NHS Direct, or out-of-hours service in primary care or a minor injuries clinic. People need rapid access to the emergency service best able to meet their need. In that connection, I am pleased to report that the out-of-hours service in the Tees valley area has been operating smoothly since April 2004.

The third element is ensuring that local hospitals are strong and modern, and can give the best possible services available to all people north and south of the Tees. I acknowledge that change is always uncomfortable to contemplate and not always popular. People sometimes like to keep things as they are, which is most true of well loved local services such as local hospitals. It is absolutely understandable that the Hartlepool "save the hospital" petition was signed by some 30,000 people.

The job of the SHA—working with all its partners in health and social care—is to look ahead and put forward changes that will save tomorrow's hospitals by making sensible changes today. The hospital services have been changing for some time and they are still changing. As I have already said, some services that used to be provided in a hospital can now be provided in primary care. Other services need to be provided in fewer places so that specialist staff and facilities can be available to provide the best possible care. Some examples of such services are those for cancer treatment, emergency surgery and the most serious accidents. I am not talking about average attendance at accident and emergency, but really serious road traffic accidents and other dramatic accidents.

The decisions to create strong, modern hospitals have already been taken in other parts of County Durham and the Tees valley area. For instance, people living south of the Tees are already served by the James Cook university hospital, which opened in 2003. The purpose of the Tees review is to establish arrangements in the area north of the Tees that will provide the best and most sustainable services for the 21st century. The Department of Health invited Professor Sir Ara Darzi to work with the SHA on the review to ensure the highest quality outcome. The professor was asked to consider how the fullest possible range of services can be maintained at Hartlepool hospital in light of the work that has already been undertaken during the Tees services review and the wider context of the proposed provision of primary and secondary care services, both north and south of the Tees.

Two additional areas were identified relatively recently as needing examination, which is why we have agreed to look at the work of the Hambleton and Richmondshire PCT and the South Tees hospital trust in relation to the Friarage hospital, and consider the impact of the centralisation of specialist services at, and the capacity of, the James Cook university hospital on other hospitals in the area.

The original time scales were not realistic, so the review has been extended and it must be allowed to be carried out thoroughly and should report when it is ready. It is important that we provide people with safe, sustainable services that are local, where that is possible. I know that my hon. Friend will share that ambition. The local health service, with the assistance of Professor Darzi's review, is looking at how best we can do that. The professor is visiting Teesside in March and I understand that my hon. Friend is likely to meet him again then. Professor Darzi is likely to submit his final report in the following months and, as he is still reviewing the situation, I am sure that hon. Members will understand that I cannot make any commitments that pre-empt the outcome of the work that he is doing.

In the remaining minutes, may I turn to GP recruiting and the work that has been done on that? The good news is that, in September 2001, there were 49 GPs in the PCT area and the latest figure is 52, which is a 6 per cent. increase. I am aware that there are still seven vacancies and the PCT has employed eight salaried GPs to provide capacity where it has not been possible to attract principal GPs to practices. The PCT has been working with the strategic health authority to develop the international recruitment of GPs. Under the national initiatives, new GPs in Hartlepool will receive the higher rate golden hello payment, which can be up to £12,000. The PCT is also looking to develop modern primary care centres providing access to integrated health and social care teams, including all the specialist workers that my hon. Friend mentioned. It is also planning to use a range of other primary care skills to help deliver that. In addition, the PCT has recruited two GPs from Spain and one from Austria.

Nationally, there are more GPs in the NHS than ever before, which reflects the Government's record investment in primary care and commitment to expanding the GP workforce. In June 2004, there were 31,215 GPs working for the NHS, which is an increase of 11.3 per cent. since October 1997. There are a range of initiatives to secure ongoing, positive developments in that direction.

We know that people are concerned about health in Hartlepool and I reassure my hon. Friend that the Department of Health is, too. The strategic health authority and the local NHS organisations are also concerned. That is why so much has been invested in health and why we will keep on investing in health in Hartlepool, which we want to be modern and sustainable for the future.

Sitting suspended until Two o'clock.