I am grateful to the hon. Gentleman for that intervention. I was not going to cover the frankly diversionary issue of choose and book, and the expensive computer and administrative system that will need to be put in place for what is a fatuous choice for people in remote areas. It is quite absurd. Most people in my area want to be treated, and treated well, in their local hospital, for which they have enormous loyalty and respect. Instead of the resources going into administrative procedures, they want them to be spent in their local hospital, which is often struggling because of the lack of those resources.
What numerical impact does the market forces factor have on a place such as Cornwall? According to the table I mentioned earlier, on which Cornwall is 11 per cent. below the national average as far as the market forces factor is concerned, the calculation made by the Royal Cornwall Hospitals NHS Trust showed that if Cornwall were just 4 per cent. below the national average, the trust would earn an extra £10 million and the primary care trust would earn £4 million. At a stroke, it would remove the deficit and put the NHS trust into credit. It demonstrates just how important the market forces factor is.
"if it is clear that the formula allocation is not working for some reason, it will be reviewed."—[Hansard, 6 April 2005; Vol. 432, c. 1554.]
I hope that the Minister accepts that there are serious concerns today about how the allocation operates.
In the national context, we must consider more widely why funding crises affect a quarter or more of NHS trusts. There is bureaucracy, and there is a large number of chief executives. Even allowing for Sir Nigel Crisp's intervention last summer, when he sought to amalgamate many PCTs, 13 chief executives still need to come together to obtain a strategic view of health services in Cornwall. That includes social services, all PCTs and the various trusts that serve the Isles of Scilly and Cornwall. At the end of the PCT amalgamation process, all we have ended up with is too few chief executives—not a big change at all.