Theresa May fails to rule out possible casualty department closures in hunt for 'efficiencies'

Challenged by Jeremy Corbyn, the Prime Minister said key decisions must be made 'at local level'

Jeremy Corbyn claimed the NHS is "on its knees", during Prime Minister's Question in the Commons

Theresa May has failed to rule out that looming NHS “efficiencies” in every part of England will end in the closure of some casualty departments.

In the Commons, the Prime Minister was challenged about the impact of new sustainability and transformation plans (STPs), ordered by NHS chief Simon Stevens.

The 44 plans – which must be finished within weeks – have already provoked fierce local campaigns against the threat of mergers, or closures, of hospital departments.

It was reported that protesters went to Downing Street last week with petitions from parts of Devon, West Yorkshire, Lancashire, Lincolnshire and Cornwall.

During Prime Minister’s Questions, Jeremy Corbyn demanded a guarantee as part of a wide-ranging attack on the state of the NHS, claiming it faces the “worst crisis in its history”.

The Labour leader said: “Next month, sustainability and transformation plans are going to be published.

“Many all over the country are quite alarmed by this, because of the threat to accident and emergency departments.

“Can the Prime Minister deal with this issue now, by quite simply saying there will be no downgrades and no closures of A&E departments?”

In reply, Ms May ducked the question – arguing decisions must be taken by local health chiefs, not imposed by Whitehall.

She told MPs: “We believe, on this side of the House, that, at local level, people should be able to make decisions about the National Health Service.

“That decisions about the National Health Service should be made by clinicians – that it shouldn’t be a top down approach.”

The Prime Minister said her Government was spending “over half a trillion pounds” on the NHS over five years, adding: “That is a record level of investment.”

Some health commentators have praised the idea of the STPS, as an attempt to ensure parts of the NHS are working together properly, after the fragmentation sparked by the 2012 Health Act.

But, at the same time, Mr Stevens, the chief executive of NHS England, has ordered the NHS to make £22bn of “efficiency savings” by 2020 – arousing public suspicion about cuts.

In heated clashes, Mr Corbyn also accused the Government of allowing funding crisis in both mental health and adult social care

The results were police holding mental health patients in cells – because of a lack of hospital beds – and delayed operations because of ‘bed blocking’ by elderly patients on hospital wards.

But the Prime Minister said Mr Stevens had asked for an extra £8bn for the NHS in this Parliament, yet the Government was delivering £10bn.

And she told MPs that £10bn would not be improving care if Labour had won last year’s general election, having made no similar commitment.

Mr Corbyn’s decision to target the NHS in the weekly Commons bout reflects growing fears that there are growing problems with its funding over the next few years.

Yesterday, Mr Stevens told a committee of MPs would funding-per-head would fall in England in 2018-19, despite the promised cash injection.