(1 year, 5 months ago)
Lords ChamberFirst, yes, that has been worked through on this. Secondly, that is one of the purposes of the consultation. Thirdly—this is the point that I was about to make—as the noble Lord will know from my contributions, I always like to follow up in writing when there is a detailed question. If I have missed anything or the opportunity to make more thorough points, I shall take the opportunity to do so.
I hope that I have given a good sense of direction of where we are coming from on this and why we feel that this provision is essential in these circumstances to protect the patients.
I am very grateful to the Minister for spelling out the criterion for minimum service levels in the health sector, which is life and limb. Can I explore that a bit further? Life and limb would obviously have applicability to A&E and, clearly, to the ambulance service. Is not the implication that that means 100% service for the ambulance service? I cannot see how ambulance staff are going to know, until they get a call, whether it is a life and limb situation or simply somebody who has fallen, is uninjured but needs helping up—or whatever the situation might be. Can the Minister assist me on that?
Yes, that is very much what happens at the moment, so that is the categorisation process that is entered into—and, from that, they categorise whether it is category 1, 2, 3 or 4, and the response will depend on that.
I shall just finish and get the point out, and then happily hear the noble Lord’s follow-up question. In these circumstances, we are saying that it is around category 1 and 2, where we really believe that there are those life-threatening circumstances.
That is absolutely understood—but is not the implication that the ambulance crews have to be in the ambulances? They cannot be standing on a picket line; they have to be in the ambulances to receive the calls. It is only when they receive the call that they are going to know whether it is category 1, 2 or 3, or whatever the specification is. Surely it follows that 100% service must be provided by the control room and the ambulance service—or have I got it wrong?
As I say, we have some good experience, because of course this is exactly what is currently happening. What is agreed between the local trusts and the unions in those circumstances is something along the lines that 50% of calls—that is my figure as an example, and please do not take it as read—are category 1 and 2. The others are not in that category, so because of that we would look for a level of workforce to cover that level of calls. Please do not take the 50% as read; I am just taking that as an example, so that the noble Lord understands the principle behind this.
I am so sorry to intervene again; this is absolutely my last intervention. If the criterion is life and limb then many of the categories listed by my noble friends Lord Collins and Lady O’Grady—community health services, pharmacists, mental health services, sexual health services and so on—can have no fear that there will be minimum service levels prescribed for them, because they are never in a life and limb situation.
Correct. I emphasise once more the process set out here: if it were decided that there was that threat, that is the point at which we would go into consultation. That is the thinking behind the process. We would have to believe that in such an area there would be a threat to life and limb, and would then go into consultation on minimum service levels. I hope that this has been helpful. It has been helpful to me as well, as ever, to see the value of the Lords. I am a big believer in critical challenge.