I congratulate my hon. Friend David Taylor, my Constituency neighbour, on securing the debate and on his lively and interesting speech.

Although practice boundaries will be the main focus of my remarks, I also want to address the wider issue of competition and choice within the NHS, because my hon. Friend has made his feelings so plain. It will not surprise him to know that I have some sympathy with a few of his points. I, too, am very conscious of the fact that our party founded the NHS. It was a service to be paid for from taxation, free at the point of need and primarily provided through the public service.

However, in respect of some of the comments about marketisation in primary care, we need to bear it in mind that the NHS has always been a deal between the private and public sectors, because most GPs operate independent private businesses that contract with the NHS, and have done since 1948. Therefore, we must be a little careful when we discuss the private sector, because some GPs talk about the private sector as if it were something different from them. Actually, they are in the private sector, but they contract with the public sector.

We have an excellent record in primary care, as confirmed by a report earlier this year from the prestigious Commonwealth Fund, but we should never be satisfied. Although many GP practices are excellent, not all are. I agree with my hon. Friend that the most deprived parts of the country sometimes have the poorest provision of primary care with fewer doctors and greater demand-poorer areas tend to have people with a number of medical conditions that need urgent care.

We cannot simply rely on current general practice to address such problems. That approach has been tried for 60 years and it just has not worked. In some places, patients may be restricted to a single practice. They may wish to move, but find it difficult to do so. That is all very well if their practice is good, but what if it is not? We are now pursuing a different approach, investing in 112 new GP practices delivered by any willing provider with a strong track record on reducing health inequalities.

Choice and competition can drive up access and quality, which is important. We are working to improve the quality of primary care in different areas. One thing that GP-led health centres have done is locate in some of the most deprived areas in the country. We have had great difficulty in getting GPs to work in such areas. They find the work hard and the profits small, because the amount of private work that they get is limited. We have invested huge sums over the past decade in new premises, new technology and many more doctors, nurses and other health care professionals.

Yesterday, I went to Barking where a new family centre has been set up. GPs and dentists were encouraged to locate in a deprived area to ensure that it offered the quality of care that local people needed. As a result of many of those people training in that area-I also visited a centre in the Isle of Dogs-some GPs and dentists have chosen to come back and work there because the facilities are good and the buildings new, and they realise that deprived areas can bring a great deal of job satisfaction.