WHY is it that every time a service is cut it is dressed up as an improvement in provision? When I visited the Young People s Service in Cambridge a few months ago I met a number of teenagers with severe mental problems for whom the service was really he

WHY is it that every time a service is cut it is dressed up as an improvement in

provision?

When I visited the Young People's Service in Cambridge a few months ago I met a number of teenagers with severe mental problems for whom the service was really helping them back into the mainstream of life.

It was obvious that to close it would put their recovery in jeopardy. It is no pleasure to know that, following its closure, there has been a suicide and a number of self-inflicted injuries. Add to that the threatened closure of Hinchingbrooke Hospital and you can't help wonder what is going wrong.

I am pleased that the present Government has put so much extra money into the NHS. After all, it is something we all take for granted and rely on in times of need. Certainly my family depends on it. It is absolutely essential that access to health care remains free at the point of use and that the NHS receives the funding it needs. But it is equally important that this money is well spent. The current crisis shows that this is not always the case.

Pointless and contradictory reorganisations have consumed far too much of the health budget since 1997. First, Labour abolished the independent NHS Executive and put the Department of Health in charge. Then they abolished the eight regional NHS offices and created 28 new Strategic Health Authorities. Later they abolished the new Strategic Health Authorities and created 10 new regional Strategic Health Authorities.

Then came Primary Care Groups, which were replaced by Primary Care Trusts. Health authorities were abolished and created all over again. The 10 major reorganisations of the NHS that have taken place since 1997 have been a monumental waste of time and money.

Little wonder the NHS has run up a deficit of more than one billion pounds - the worst in its history. The organisations which actually provide front-line care - Primary Care Trusts (which pay for GP and community nursing services) and NHS Trusts (which provide hospital services) - have borne the brunt of this worsening financial position.

East Cambs and Fenland PCT received nine per cent less funding than the English average; the local NHS trust lost 50 beds last year and the Strategic Health Authority which covered this area had a deficit of £100m - the second largest in England. Across the country, more than 18,000 job losses have been announced: hospitals and wards are facing closure; trainee doctors and nurses are unable to find posts; and more than 2,000 beds have been lost since April alone. In the meantime, managers are re-applying for their jobs as a result of another reorganisation. It is a bleak picture.

These cutbacks in services, without anything to replace them, will seriously damage the standard of patient care. They are the result of ministerial meddling, waste, inadequate planning and unfair funding which means that NHS Trusts, which finish the year in deficit receive both a cut in their budget equal to the deficit in the next year, and also have to repay the deficit from the year before.

Patients, nurses and doctors should not have to put up with botched reorganisations, inconsistent policies and now cutbacks and closures. Local people should not be paying the price of policy failures. The design of local NHS services should be a matter for local people, but instead key decisions are being taken far away from them, behind closed doors and without consultation.

Changes are necessary in the NHS. But it is changes of culture, which bring about far greater professional responsibility and hand control of our NHS services back to local people that are required.