If the hon. Gentleman will allow me, I will come to that.
The truth is that we have made enormous strides in the quality and quantity of services that are provided to the general public and to patients of the health service. We have thousands of extra clinicians throughout the country. We are replacing old buildings with new hospitals or surgeries, and providing new ambulance stations and ambulances, some through the PFI route. My hon. Friend David Taylor, who is not here, might quarrel with me about that but he would acknowledge the role that private finance initiatives are playing.
In 1997, the Royal Cornwall trust had 102 consultants. Now there are 184. The hon. Member for St. Ives spoke about the concerns about budgeting at the trust, but the plans that it has in place involve improving efficiency in management and administration. It will also, as it says in its press release,
"be fundamentally reviewing how we deliver patient care services, through" service redesign. In particular, it will be
"concentrating on improving day surgery rates, theatre utilisation," improving
"length of stay and reducing the numbers of patients who fail to turn up for appointments."
All those steps will result in improved patient services to those patients who use the trust.
Instead of being criticised for making sensible proposals about how to manage their resources more effectively to deliver improvements in services for local people, which is what the hon. Gentleman is engaging in with his local campaign, management in the area should be commended for their actions and supported in their proposals. We are working with those organisations that face the biggest problems, and sending in the expertise to help them address their problems of poor financial management.
Tony Baldry asked whether health service organisations were over-trading. To some degree, I agree with his proposition. Waiting lists have virtually gone. Patients are managed in a different way and the pressures on services are changing. Top-slicing has been raised by a number of hon. Members. Strategic health authorities are agreeing locally what arrangements should be put in place to help all the organisations in an area to organise their finances so that they continue to deliver improving services. The hon. Gentleman might say that we are dictating the way forward, but that is actually arranged locally through systems that have been used in the past. Deficits might traditionally have been managed by one part of a SHA area helping another out—that continues to be done in Liverpool, although Liverpool did not always have the extra resources that it now has. I remember the days when there were serious inequalities in areas such as the one that I have the privilege to represent and the struggle that the health service had to deliver even decent services to the local community.
The overspending in the NHS and the over-performing remain a relatively small proportion of the overall budget. All areas of the country—