It is clear from Surrey PCT that there is a funding shortfall of £120 to 150 million across the county for 2011, due to rising costs and demand for services. We need a grown up conversation about how to make the best of a difficult situation. That means a proper public consultation - across Elmbridge and Surrey - with everyone concerned, including most importantly the public. For too long, consolidation and cuts - for example, Burwood ward at Walton hospital (below) - have been dressed up as efficiencies, which only undermines local confidence.

In Elmbridge, we need a much clearer sense of strategic direction, for example, in the area of intermediary care. We need to look very carefully at the role of our community hospitals. They may be obvious targets for the bean-counters, but local communities place an enormous value on having their services close at hand - an intangible value, which is not picked up by Whitehall targets and performance indicators. If scarce resources really need to be invested elsewhere, the NHS trust must make the case publicly and convincingly - rather than avoiding tough choices. I welcome Mr Lee's recognition that we need such an open and transparent process, as we move forward.