Only a few days to go: We’re raising £25,000 to keep TheyWorkForYou running and make sure people across the UK can hold their elected representatives to account.Donate to our crowdfunder
I am grateful for that question, because I believe that the ambulance service should be an integral part of the national health service. We also believe that the NHS should be an integral part of local democracy, as should the police and fire services. The ambulance service should work with local doctors who work out of hours and with local casualty departments, so that local flow patterns can be established.
The important point that the hon. Gentleman is making is that the emergency services must work together. I have been disappointed that successive Governments have tried to improve efficiency by making the control systems and units of the ambulance service, police and the fire brigade bigger, but retaining their isolation. That may produce a regional fire brigade, ambulance and police service, but we need an integrated emergency service, which could also include civil defence and out-of-hours social services provision. In that way, each locality could provide an appropriate response to an emergency. That would eradicate some of the problems that have been highlighted during the debate, such as that of people who inappropriately contact the ambulance service. We cannot blame people for doing that if they do not know whom they should contact. NHS Direct should be able to cope with that problem, but, in my experience, it does not always get it right. I hope that it will do so in time.
It would be much better if local services were integrated. Hampshire is almost too big for that, but the health authority areas should be able to integrate some of their services. Some services would need to be town or city based, whereas others are obviously more rural. There are different response requirements in different places. Rural areas tend to be more self-sufficient. That does not mean that they should not receive a five-star service, as my hon. Friend the Member for Romsey said, but local general practitioners are often more responsive to out-of-hours work and there is more collaboration between the ambulance service, medical and even pharmaceutical services in rural areas.
This is a valuable debate, which is not only about Hampshire, but about how the Government see the interaction between the people who need the emergency services and those who provide them. I hope that they will not take the bean-counting route of "bigger is better" and look only to make efficiency savings in the cost of telephone operators, but that they will have regard to the quality of service that will result from the structures that they are considering.
I would be horrified if ambulance services on the Isle of Wight were forced to amalgamate with those in Hampshire because amalgamation of the police service has not been good for us. There is a risk that we will do just as badly from an amalgamation of the fire brigades, and I believe that amalgamation of the ambulance services would be a disaster.