I congratulate Mr. Turner on securing an important debate. Regulation is about ensuring that we maintain the quality and standards of the national health service throughout the country. We know very well that a failure to ensure that quality and standards are maintained can lead to problems such as those at Mid Staffordshire. We do not want a repeat of those problems anywhere in the country or, indeed, a repeat of the issues that we have seen at Basildon and one or two other hospitals, which, although they were not on the scale of the Mid Staffordshire debacle, were certainly worrying for the health service as a whole.

We have a health service that throughout the country provides, by and large, a good quality of care for patients. Individual examples of hospitals that fail always hit the headlines and may contribute to a disproportionate public perception of the NHS. However, as a result not only of the standards of professional competence for health professionals and managers in the health service, but also of regulation, by and large, the standard of the health service is good across the country as a whole. We need to ensure that we keep monitoring the quality of that health care and that we have the proper criteria and mechanisms to do that.

The country differs greatly. There are various local frameworks for the NHS and methods of organisation to which we cannot possibly address a national system of regulation. The Isle of Wight is in many ways almost unique in how it delivers health care. The hon. Gentleman is right that the standard of care provided on the Isle of Wight is in the category of excellent. The way in which it is delivered is a result of the particular circumstances. Like many people, I am familiar with the Isle of Wight from going on holiday there-I cannot remember on how many occasions, but it is a significant number. It needs to be recognised that because of that situation, the Isle of Wight has to deliver health care in a particular way, and it does so very well indeed.

I can well understand that the health professionals and managers and those who have to deal with NHS finance are concerned that the way in which regulation occurs on a national basis does not accommodate the Isle of Wight's particular circumstances. There is a strong argument that that is the case and the hon. Gentleman has very eloquently put it. Other parts of the country might advance similar arguments that the way in which regulation occurs does not fit their circumstances. I am not sure that they are all quite as unique as the Isle of Wight. None the less, there are many different ways of doing these things. If we had a national system of regulation that was tailored to each area, we would be getting into a very expensive and complex system of regulation, and we cannot do that, but that does not mean that we cannot help the Isle of Wight. I shall come back to that issue in a moment.

The hon. Gentleman raised the key criteria by which regulation occurs-targets, for example-and asked whether there should be quite so many targets. We are conscious that some health professionals have said to us, "Look. Targets are important, but there are too many and you must not only put them in but, when they have done their time, take them out." We accept that and are examining some of the targets on waiting times. Some of those are, in a sense, bypassed because the waiting times are now so short that we have hit the target and gone well beyond. Therefore, the health service does not need some of those targets, but when we have a national health service, we do need to have national minimum standards across the health service as a whole, particularly on waiting times-four hours in A and E, 18 weeks for an operation and two weeks to see a cancer specialist after referral by a GP. Those are basic standards of health that the health service throughout the country should provide.

When we have gone through a period during which the taxpayer has put in vast amounts of extra money-it depends how we look at it, but there has virtually been a tripling of the budgets of the health service-it is important that the taxpayer knows that something tangible and measurable is coming out of that extra investment and that it meets a basic minimum standard and is better than what was provided in parts of the health service in the past. That is why I am a defender of targets. We now wish to move from managerial targets to guarantees for individuals, so that each individual would have the right to enforce a guarantee in their own case. I believe that we could do that in fairly short order if, perchance, we were to win the general election-a matter for the electorate. I am a strong defender of those measurements of what we, as taxpayers, are receiving for the extra investment and higher taxes, and it is higher taxes that we pay to ensure that the NHS is properly funded.

We are talking not just about the NHS: in areas such as the Isle of Wight, there are a number of other services, which are linked up, so a lot of targets end up being built up for the ambulance service, the hospitals and primary care services. I understand that, but we are putting in a lot of extra money. Therefore, there is a justification for those targets and for applying them on a national basis, so I make no apologies for saying to the Isle of Wight, "You, too, as an authority, need to comply with the basic minimum standards of the country as a whole."

The question then is how we ensure monitoring of compliance and the overall general standard of health care and other services provided, and whether the system of regulation is proportionate to the particular circumstances in a place such as the Isle of Wight. I share the hon. Gentleman's concern that regulation, particularly in the area that he represents, should be proportionate and should recognise the particular local circumstances, but at the same time it needs to be national and should not become so diversified that it cannot properly compare services throughout the country. Everyone should know basically what is being regulated.

Our new regulator, the CQC, will cover a much broader range of services than previous regulators, so we have brought different aspects of regulation together. The CQC has adopted what is called the gate-keeping role, which requires it not to impose a whole series of regulation inspections and visits in a disjointed and ad hoc way, with different groups arriving at different times and disrupting everyone. Instead, it should take a reasonable and proportionate view of how it regulates the system as a whole. In a sense, it should also gate-keep itself so that it does not carry out inspections and reviews in a way that imposes a disproportionate burden on particular areas.

The CQC has become aware of the problems of the Isle of Wight. That is due in no small measure not only to representations from the various local health bodies, but to the fact that the hon. Gentleman has made sure that the concerns of the Isle of Wight are raised. The CQC will seek to apply the gate-keeping role and to be proportionate and reasonable in carrying out its regulation. I cannot guarantee the hon. Gentleman that there will not be a series of regulatory visits. That is mainly because different regulators regulate different things, so they cannot all turn up at the same time, do the same regulation and disappear at the same time.

There will therefore be a need to manage things in a way that is reasonable for both sides. That will allow regulators to take a view that there are particular circumstances in the Isle of Wight and that they need to gate-keep the regulatory burden to ensure that it is not disproportionate. On the other hand, it will allow people in the Isle of Wight to recognise that regulation in its different forms may impose a burden that is unwelcome, given that the Isle of Wight is in the excellent category, but that that needs to happen to ensure that there is national regulation.

One benefit of being in the excellent category, and one way in which we have changed things recently, is that regulation is much more risk based. Every hospital will have a visit every two years, but some will have visits more regularly-every few months-because they need them and are regarded as high risk. However, given that our approach to regulation is risk based, some hospitals will have fewer visits because they are in the excellent category. High-quality services of the kind that the CQC recognises, at this point at least, in the Isle of Wight should need less regulatory intervention than lower-quality services.

As we all know, services can change, so regulation must change with them. An excellent service can become a not-so-good service, so services must continue to be monitored and regulated. At the same time, where there is a level of excellence in a service, we need to ensure that the regulator can say, "We don't need to visit them quite so often. When we do visit, we can perhaps do it in a more appropriate way, because there is less of a problem there from what we already know." If things changed, however, and the service deteriorated, the level of intervention and the unannounced visits and so on, which are needed if there is a problem, would necessarily increase. What I have said is not, therefore, an indefinite guarantee for the Isle of Wight; it simply recognises that if a service is seen as high quality and can demonstrate when visits take place that it remains high quality, the number of visits need not be as high as they would be otherwise.

That is a positive message for the Isle of Wight. It has developed a unique approach to the health service that is appropriate to it. As the hon. Gentleman said, 92 per cent. of patients admitted to St. Mary's hospital in Newport were happy with their treatment, although the figure that I have is 93 per cent. We can quibble over the 1 per cent., but the public seem very happy by and large with the way in which services are provided. I hope that the standard in the Isle of Wight will remain one that requires a proportionate system of regulation.

The hon. Gentleman asked me to take up the issue of guarding prisoners outside prison, and I will make some inquiries on his behalf about what is happening on that. Having set out some of the issues, however, I hope that I have dealt with most of the points that he raised. In those circumstances, I need not detain you any further, Mr. Cook.