East Midlands Ambulance Service

Andrew Bingham Excerpts

Monday 21st January 2013 Commons Chamber

[Anna Soubry]

As ever, my hon. Friend makes an important point, and it is one that I will certainly look at further. I hope that those in EMAS who are listening to the debate will take that comment on board.

In response to the points made by the hon. Members for Ashfield (Gloria De Piero) and for Chesterfield (Toby Perkins), I do not think that it is as simple as saying that the closure of an ambulance station will de facto reduce the service available. Ambulances do not sit in ambulance stations waiting to respond to a local incident. They spend most of their time out of ambulance stations on the road so that they can respond to emergency calls. EMAS reported—these are important facts that should be widely publicised; I am sure the hon. Member for Bassetlaw will ensure that they are—a total turnover of £169.5 million in its 2011-12 final accounts and a £1.4 million surplus. It has also reported surpluses in the previous three years. I understand that for 2012-13 the trust received £3.5 million funding as its share of the EMAS contract from Bassetlaw primary care trust. As I have said, my concern is not so much about the money, but about the way the service is being operated.

Let me turn to the “Being the Best” review. EMAS tells me that it recognises that its response times in rural areas do not match the response times in city centres. In response, EMAS published its “Being the Best” change programme in 2012, which outlined plans designed to ensure that response times and the service provided to all the people of the region were improved. As the hon. Member for Bassetlaw described, EMAS has consulted clinical commissioning groups, overview and scrutiny committees and local people on its proposals. As we have been told, it received substantial feedback from the people of Bassetlaw, with a petition from some 9,000 people. The business case should be presented to the board on 25 March, allowing the trust additional time to review alternative options and develop final proposals for the board to consider.

I am told that a number of options are being considered. They include the “do nothing” option, which involves making no changes to the configuration of ambulance stations; the “do nothing-plus” option, which involves making no changes to the configuration of ambulance stations, but making an additional resource investment in more ambulance vehicles and staff; and the “do minimal” option, which involves making the minimum changes necessary to deliver current service standards in a safer and more effective manner. That option would retain all the current stations and introduce the 118 new community ambulance posts. The fourth option would establish 13 hubs, plus 118 community ambulance posts—I know that my hon. Friend the Member for High Peak (Andrew Bingham), along with many hon. Members, has expressed his concern about that option. The fifth option—a new option—would establish 27 hubs, plus 108 community ambulance posts, and is being considered as a direct result of the consultation feedback.

[Andrew Bingham (High Peak) (Con)]

Does my hon. Friend think, like me, that although the hub and spoke model has merit, the key is where the hubs go? High Peak is very rural; we need a hub, as I am sure the hon. Member for Bassetlaw (John Mann) feels he does.

[Anna Soubry]

That is a very good point. My hon. Friend has summed it up—we are having an outbreak of cross-party unity. As he says, the key point is the positioning of the hub. One of the attractions of the hub approach is that the mechanics would be in place to ensure that the vehicles were ready at the beginning of a shift. At the moment, paramedics are responsible for that, which does not seem to be a very good use of their time. There is therefore much merit in establishing 27 hubs in the right areas to ensure that we have a service that is fit for purpose.

There is something else that needs to be, not so much explored, perhaps, as exposed. The hon. Member for Bassetlaw has quite properly commented on the difficulty of having targets, and I could not agree with him more. This debate is a good example of where top-down, Government-led targets have blighted an ambulance service—no doubt there are many other examples in the NHS. That is why, when this Government were elected, for many of us it was on the basis that these targets, far from freeing up services and making them better, were strangling them and making them worse. This debate is an example of targets doing all the things they were designed not to do, constricting a service and making it worse. It is worth bearing it in mind that it was in 1997, I believe, that the ambulance service suffered from such targets. I hope that there will be more cross-party agreement and moving forward, so that although there are laudable aims that all services should have, we should not necessarily set rigid targets, which then create exactly the sort of horribly sad cases that the hon. Gentleman told us about.