I was not aware of those targets; perhaps the Minister could clarify them, but I thought that the 95 per cent. target related to a 19-minute response time. I hope that I was wrong.
There are new problems associated with the measures that are being introduced to reach response targets, specifically with the use of rapid response vehicles. They are crewed by one person only, and the aim is for that paramedic to arrive within eight minutes--so that the targets are reached--to stabilise the patient. However, because a rapid response vehicle then requires the back-up of a fully manned ambulance, the system is heavy on staff. If it saves lives, every penny will be well spent. However, what assessments have been made of the various ways of dealing with emergencies? Are overall outcomes better when a paramedic rapidly arrives on the scene or when transport to hospital is regarded as a priority? Those are fundamental questions, to which I have as yet been unable to find the answers.
I ask those questions because of a recent highly publicised case in Havant, which illustrates the problem. A motor cyclist was injured and a paramedic arrived--17 minutes later, although that is not the point in this case. A fire crew were already there and had administered first aid, but the patient then lay waiting in the road for another 30 minutes as his condition deteriorated. All ambulances in the area were tied up, so the firefighters took the decision to transport the injured motor cyclist in the fire engine. Obviously, fire engines are not designed for patient transport, and one fireman had to kneel on all fours to support the stretcher on his back, while a second fireman sat on the floor to hold the stretcher and prevent it from moving. If that does not illustrate the fact that Hampshire ambulance services are overstretched, I do not know what will.
Hon. Members should not be lulled into a false sense of security by convincing themselves that that story was a one-off. I have been told of several incidents in which firefighters have ended up either driving an ambulance or attending to a patient in the back of one; such incidents are almost always as a result of a singly manned ambulance arriving at the scene. We all know that ambulances should have two ambulance men on board.
Coincidentally, I picked up a copy of the Andover Advertiser yesterday, which had the front-page headline, "Ambulance crisis looms". I notice that
"Andover firefighters are becoming increasingly concerned about the time it's taking ambulances to arrive at incidents. They say financial limits imposed on Hampshire Ambulance Service are putting firemen under increasing pressure. But the ambulance service is denying there's an ongoing problem.
'We're frustrated and angry,' said Lud Ramsey, Andover's Fire Brigades Union representative. 'Ten years ago we would have attended fire calls, road traffic accidents etc. and we knew the ambulance would be only minutes behind us.'" I have heard from a high level in the Hampshire fire authority that those incidents are being repeated in towns throughout the county. Indeed, the fire service is facing demands from firefighters for more first aid training and is considering whether defibrillators should be standard fire engine equipment. That is because firefighters feel that they can no longer rely on ambulances to arrive quickly enough.
When I was out with the ambulance service, one incident brought home to me the fact that ambulances are sometimes called out for what can only be described as non-urgent reasons. A letter in the Romsey Advertiser from Liam Sizer, the southern area convenor of Unison, sums that up. It says:
"Calls to people with rings stuck on fingers; to people with minor cuts often needing no more than a small Elastoplast; to people with toothache, earache and backache; to people who have been feeling 'unwell for a few days and it's not getting better' (I could go on, but it would become boring). These people account for such a large proportion of 999 calls that they are the biggest cause of the delays experienced by patients who really do need our speedy attention.
Finally, could I please ask that all people, notwithstanding where they live...make sure that their house name or number is clearly visible as close to the road as possible."
I urge the Minister to consider running a public information campaign in a similar fashion to that aimed at dissuading people from calling out their general practitioner for trivial reasons. Abuse of the system costs money and lives.
The final item on the agenda is the proposed merger of the Hampshire and Surrey ambulance trusts--mentioned hon. Friend Mr. Chidgey--which will shortly go out to public consultation. To show my linguistic roots for a moment, let me say that the merger strikes me as a completely barmpot idea if ever there was one. I have not seen the final consultation document, but the following points need to be addressed.
Bigger is not necessarily better, but often results in an extra tier of management. Cynics have pointed out that, before the merger's announcement, the Hampshire ambulance trust board mysteriously increased in size and most new appointees were people who had recently retired only to return suddenly. Many people regard that as a cynical ploy to appear to be cutting jobs when, in reality, a few jobs were created for a short period to provide a cushion. The reality is that most long-serving people will keep their jobs under the new scheme.
Change is disruptive. Hampshire is experiencing problems in trying to get to grips with the new control system and is still nowhere near achieving the targets. Further disruption will result only in a worsening of response times in the short term, with no guarantee of an improvement in the long term.
Many people in the ambulance service regard the merger as a done deal, because it has been said that the status quo is not an option. Although I am here today highlighting problems with the status quo, I am still not convinced that there are any advantages to the merger. Surrey and Hampshire are not natural partners. Hampshire looks more readily to Dorset and Wiltshire, but those counties are now officially in the south-west, so we cannot consider a merger with a more like-minded county. The huge problem is that Surrey is an urban trust with urban response targets, but, as has been mentioned, Hampshire is rural; so what targets will the new trust have? I am sure that Surrey will not settle for a diminution in service, but it will cost a considerable amount of money to bring Hampshire up to Surrey's standards. Hampshire is not even meeting its own standards at the moment, so heaven help us if we have to achieve higher standards.
In addition, reorganisations cost money. Who will pay for reorganisation? Hampshire secured extra funding this year only because it demonstrated that there was an operational need for it, but that need does not cover the likely costs of reorganisation. Why is the merger proposed when Operational Research into the Health Service conducted a survey two years ago on the regional office's behalf and concluded that there would be no benefits in a merger? There will also be pay differentials, as the two trusts are paid differently. I do not believe that recruitment and retention will be improved.
If the Minister is minded to consult on the scheme, I ask that the consultation be real and, if opinion is against it, for her to take note of that. Will she also make clear the cost to the public purse of the proposed administrative upheaval?
The speech that I have made today may sound somewhat negative. Most people who call for an ambulance get one quickly, but the problems that I have highlighted show that the system is under considerable strain. There needs to be serious consideration of Hampshire Ambulance Service NHS trust and other trusts to try to sort out some of those problems.
It would help if we had a set of national standards and guidelines that were matched by funding that automatically meant that those standards were attained. Clear accountability is also needed, because one thing that I have noticed in all this is that no one seems to have put their hand up and said, "It's our fault."