But it is wrong to assume that new investment should take place without a commitment to modernising the way in which health care is delivered. Advances in drugs and healthcare technology as well as the fact we live longer and have higher expectations of health care mean that we must regularly scrutinise the way in which the NHS serves us.

I welcome the public consultation that is taking place in West Cumbria on the future of acute hospital provision. Government policy is clear: health services must recognise that people want more, not fewer, local services and that services should be designed in conjunction with patients and not just for them.

Therefore, we should not characterise the current consultation as a simple question of the future of the West Cumberland Hospital. It is not just the future of our hospital and the Cumberland Infirmary that is under consideration; it is the whole of health service delivery in North Cumbria. We have to look at how all providers of health care: hospitals, primary, intermediate and social care providers work together and integrate their work to serve the community most effectively.

We will continue to need hospital provision for West Cumbria and I am certain that whatever happens there will be a hospital serving West Cumbria. But modern management of chronic conditions and the emphasis on caring for the elderly in their own homes should mean fewer people being admitted to hospital. And if new types of provision are introduced to West Cumbria they will follow similar provision that has been piloted or introduced by other trusts with dispersed populations elsewhere in the country.

It is also important to remember that, although the Trusts must live within their means, in contrast with previous attempts to reform services in the eighties and early nineties the current consultation on reforms is taking place in the context of massive increases in resources.

Over the Summer I met both the Chairman of the Acute Hospitals Trust, Eric Urquhart, and Anne Glazebrook, Vice-Chair of the Joint Committee of the North Cumbria Patients' Forums both to give my views and to encourage public involvement.

The process of considering options for the Acute Hospital Trust will continue until the Spring of 2005. Everyone will have ample opportunity to express their views and I urge everyone to make their views known through the consultation process.

An acute hospital will be retained in West Cumbria. What we have to ensure above all is that it is "fit for purpose" and delivers a full range of high quality hospital services to the people of West Cumbria. That way the continued investment in health services will meet its objective of improving health care for everyone.