I am grateful to have secured this debate on the Isle of Wight NHS primary care trust and its regulatory burden, and I welcome the Minister who is going to respond.

As hon. Members are aware, nationally set targets and inspections are seen by the Government as the best way of ensuring high-quality patient care in a primary care trust. Too often, however, such targets are counter-productive; visits by patients to hospitals and doctors are important, not visits by inspectors. Targets are regarded as a burden to be shouldered rather than a catalyst for best practice, and national priorities get in the way of effectively responding to local needs.

The NHS is a national organisation, but health care is delivered locally whether in the surgery around the corner, the hospital in the larger town or the ambulance anywhere, any time. The population of the Isle of Wight is in excess of 130,000 people, and less than half that number would usually support a district general hospital. Let me be clear: there are no road or rail links to the mainland. Patients transferring off the island are dependent on the weather, so St. Mary's hospital in Newport is essential. When health care in the south-east was reviewed four years ago, it was recognised that the island's health service needed to be organised in a different way. Established in October 2006, the Isle of Wight NHS primary care trust is a single organisation that combines the commissioning function and the provider function for all health care on the island. That is unique in the NHS in England.

On the mainland, ambulance, hospital, mental health, community, learning, disability and primary care services are the responsibility of separate trusts. On the island, however, they all fall under the remit of the Isle of Wight NHS PCT. For patients, the merits of such a unitary approach are borne out by the evidence, which suggests that fewer patients are referred to secondary care on the island and that more patients return to their homes following hospital discharge. Care for those with long-term conditions is of a very high standard.

In a recent survey, 82 per cent. of islanders said that they were satisfied with the local NHS; 90 per cent. were satisfied with the local ambulance service; and 92 per cent. were happy with their GP. Indeed, in the Care Quality Commission's 2009 annual health check, the Isle of Wight was one of only three PCTs in the country to receive an "excellent" quality rating.

I can speak personally about the outstanding quality of care because in 2006 I suffered a stroke. My recovery-and the fact that I am standing here today-is testament to the hard-working doctors and nurses on the island, and I would like to pay tribute to the dedication of all health care professionals on the Isle of Wight. Without them, our unique system of health care would not be possible.

Through working in partnerships, the PCT delivers a comprehensive and cost-efficient service, but its unique nature has not been recognised in the national inspection regime. We have a single Isle of Wight NHS organisation that should be recognised with a unified set of inspections and targets. Instead, however, each part of the whole is held to account as though it were autonomous, and is monitored separately. Although that may be right for other places, such an approach is not valid on the island and leads to an unhealthy level of targets and inspections being imposed on a single health authority. That disproportionate regulatory burden threatens to undermine the benefits of a joined-up approach.

The island's PCT receives up to 70 external visits from 20 different regulators or monitoring bodies. No other PCT or trust is subject to such intervention. Furthermore, for 2010 and beyond, the Care Quality Commission has proposed 13 special reviews for NHS trusts, and it is likely that all of those will apply to the Isle of Wight's PCT. It could get to the point where it becomes necessary to employ people full time simply to satisfy the demands of bureaucracy. That represents money that could be better spent on the front line.

In his response, will the Minister tell me why such a level of visits is necessary, and why they cannot be more effectively co-ordinated? Nationally, each individual trust is subject to separate targets. For example, acute trusts currently have 10 existing and 14 new national priority targets to reach. Mental health trusts have 12 national priority targets while learning disability trusts have five. Ambulance trusts have four existing and six new national priority targets, while primary care trusts have 14 existing and 24 new national priority targets to meet.

Although I do not agree with such numbers, for the sake of argument I accept that such a division of targets is necessary on the mainland. However, on the island it means that our single PCT has 28 existing and 61 new targets to achieve-89 in total. Such a high number does not apply to any other trust or PCT, and such excessive national targets simply do not correspond in the case of the Isle of Wight. Will the Minister indicate whether such a level of targets is necessary for an organisation that exists outside the organisational norm?

More generally, I question whether such a level of targets really caters for the best interests of patients. We need only look at the tragedy in Staffordshire, where managers were motivated more by central targets than by patients who needed treatment. The Government must ensure that targets help to provide for patients' needs rather than taking money away from front-line care.

On the Isle of Wight, the burden of regulation not only places demands on the time of professionals that could be better spent treating people, but imposes a heavy financial burden. I am told that all NHS trusts and service providers will have to register services with the CQC by October this year. For the Isle of Wight PCT, that means 18 different service types across 12 different locations. Such a level of bureaucracy for a single organisation is bad enough, but from 1 April 2011, an annual registration fee will be required for each service provider. The Isle of Wight PCT is an amalgamation of many local providers, and such fees could therefore have acute financial consequences. Will the Minister give me an assurance that when the new fees system is put into practice, he will look carefully at the fees that the Isle of Wight PCT will have to pay?

On the whole, the Isle of Wight PCT seems to be being penalised for its unique nature. Over and over again, we see the organisation contorting to fit into the inspection regime when it is the system that should adjust and adapt to the organisation's circumstances. Will the Minister review the level and type of regulations for such a unique organisation and, in doing so, give scope for a more flexible approach? If we attempt to push inappropriate national criteria on a local organisation, we run the risk of undermining the benefits to local people.

While I have the Minister's ear, I should like to mention one other matter. On 4 November 2009, the Prime Minister gave me an assurance at Question Time that the excessive cost of guarding prisoners receiving health care outside prisons would be dealt with. I was surprised to hear from my local PCT that it has heard nothing further from the Government on the matter. Will the Minister kindly ensure that that, too, is followed up?

The Isle of Wight health service is full of dedicated professionals who want to be able to get on with what they are paid to do-caring for my constituents and visitors to the Isle of Wight, not filling in endless forms to meet meaningless targets.