Air Ambulance Funding

Edward Argar Excerpts

Monday 26th April 2021 Westminster Hall

[The Minister for Health (Edward Argar)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the hon. Member for Linlithgow and East Falkirk (Martyn Day). As the shadow Minister, the hon. Member for Nottingham North (Alex Norris), said, when members of the Petitions Committee turn their hands to giving extremely well-informed and erudite speeches on whatever topics come through the Committee, they display a certain dexterity. I pay tribute to the hon. Member for Linlithgow and East Falkirk for his thoughtful speech, as ever, and to my hon. Friend the Member for Wakefield (Imran Ahmad Khan) and the shadow Minister, who made typically measured, sensible and thoughtful contributions to this important debate. Although what goes on in the main Chamber may attract more public attention, I often think that if more people were aware of what goes on in this Chamber, they would find that the tone of many debates is different from the one at the Dispatch Box in the Chamber, and that there is a genuinely constructive exchange of views.

As the shadow Minister said, to date more than 130,000 people have signed this petition, and I thank them all for highlighting this important issue for debate. Like him, I pay particular tribute to Bethany for her work in getting such a huge number of signatures for this petition and echo the words of other hon. Members in sending our sympathies to her family. If I may slightly crave your indulgence, Mr Stringer, although this is not directly related to air ambulances, I will take this opportunity —I suspect it may be the only chance I have to do so before Prorogation—to put on the record the condolences and sympathies of all in the House to the family and friends of ambulance technician Jeremy Daw, who was tragically killed at the weekend when on duty when his ambulance was hit by an object. It is important to put on the record our sympathies and condolences to his family and friends.

I pay tribute, as others have done, to the air ambulance charities and to their critical care teams of doctors and paramedics, who are among some of the most highly skilled pre-hospital clinicians in the world. They are capable of performing life-saving hospital-level procedures on patients at the roadside and saving lives. That includes administering general anaesthetic and, indeed, open heart surgery. When a life-threatening injury or medical emergency happens, patients need to be transferred to hospital as quickly as possible. In some cases, survival can depend entirely upon the vital life-saving work of the UK’s air ambulance charities. Air Ambulances UK figures show that, on average, air ambulance charities across the UK collectively complete more than 25,000 of these life-saving missions a year. To put that another way, as the shadow Minister did, every 10 minutes an air ambulance helicopter takes off somewhere to attend an accident or medical trauma.

Last year, I had the huge privilege of visiting the amazing charity London’s Air Ambulance. I saw at first hand the amazing work of the crew who undertake their life-saving missions day in and day out, working alongside the staff of the Royal London Hospital and the London ambulance service to care for the most critically ill patients. I pay tribute to the team there who showed me around—their comms team includes a former member of a member of my staff who now works there, Kirsty McKellar—for their forbearance as I displayed, shall we say, certain symptoms of vertigo while I climbed a ramp to the top of the hospital to see the helicopter on its pad.

The shadow Minister highlighted the cost of every take-off and every mission, so he will be reassured to hear that I did not avail myself of an opportunity to go up in the helicopter; that would not have been a good use of funds. However, I was able to talk to the team and to see their work at first hand. They were clear that they are incredibly proud of their charitable status and their work as a charity. They quite rightly raised a number of issues with me, one of which I will put on the record now: they ask that councils in London and those who have open spaces are always mindful of the need to try to keep those spaces accessible for London’s air ambulances so they can find somewhere to land in this busy city in which we stand today. I was incredibly grateful to the team not only for showing me around the air ambulance and showing me their procedures, but for their amazing work day in and day out. Indeed, I put on the record my gratitude to all the air ambulance charities.

We recognise that air ambulances provide an invaluable service to our NHS. They support the NHS emergency response on the ground and ensure patients get specialised care in both urban settings and hard-to-reach rural areas. Air ambulances also provide additional support to on-road ambulances at times of high demand through the use of critical care cars to increase capacity and ease pressures on NHS services. Additionally, air ambulance services have supported the national covid-19 response by using their aircraft to transfer patients, doctors and equipment, including medical supplies, between hospitals.

I turn now to the heart of the petition and the debate. Although air ambulances provide services to the NHS, it is right that they are not directly funded by the NHS, and that the majority of their resources are drawn from their fundraising activities. That is something that the air ambulance charities support, as hon. Members, particularly my hon. Friend the Member for Wakefield, have alluded to. As the hon. Member for Linlithgow and East Falkirk set out, it is not about the predictability or certainty of Government funding; there are other things that make the charities support the current model. For example, Anna Perry, the chief executive of the Great Western Air Ambulance Charity, said, “In terms of funding and our day-to-day costs, we value the independence our charitable funding provides us. If we identify that our patients need a different kind of treatment or approach, then we can be responsive to those needs. We cover a diverse area, from the Forest of Dean to Cirencester, and from Bath to Weston-super-Mare, and our funding means we remain flexible and innovative in responding to what our communities need from our life-saving service.”

Similarly, the chief exec of the Lincolnshire and Nottinghamshire Air Ambulance said, “While there are benefits to being Government-funded, as an independent, highly regulated charity, we greatly value the ability to be flexible to the changing needs of our patients—for example, by having the ability to quickly adapt to new technologies and medicines. The Lincolnshire and Nottinghamshire Air Ambulance”—I believe it covers the constituency of the hon. Member for Nottingham North—“is very much a part of the communities we serve. We are funded by them and are accountable to them.”

I will share a final quote to emphasise the view from the charities. Amanda McLean, who is the chief executive of Thames Valley Air Ambulance, said, “Operating within a charitable model allows air ambulance charities up and down the country to provide efficient, responsive and tailored care to best meet the needs of their communities. By working independently, embedded within our local areas, we are able to collaborate and share best practice while offering a service that is targeted to meet the specific challenges we each face.”

Those are a few examples, and hon. Members have given similar examples from different chief executives of different charities. As the shadow Minister said, it is important that we listen to what the charities that run the air ambulances are telling us.

As has been alluded to, that is not to say that the Government do not provide significant support to the sector. In 2019, the Department of Health and Social Care launched a three-year capital grant programme, which allocated £10 million to nine air ambulance charities across England. These capital schemes provide a range of new equipment and upgrades to support air ambulance services to move towards 24/7 operations, allowing more patients in need of an emergency response to be reached. The funding will also support the modernisation of facilities at seven air bases across England, including building interactive training suites to better prepare crews for challenging conditions, with the addition of seven new critical care cars and a new helicopter.

As hon. Members have mentioned, last year the Government announced a further £6 million of covid-19 emergency funding for Air Ambulances UK to distribute to the air ambulance charities in order to ensure that each charity could continue to provide its life-saving services during the pandemic. Like the shadow Minister and hon. Members who have spoken, I believe that was the right thing to do, as the charitable fundraising activities that they would normally undertake were clearly impacted on by the constraints imposed by the pandemic and the restrictions that were necessary to tackle it. Of course, we support air ambulances through close collaboration with the NHS. For example, NHS ambulance services commonly provide key clinical staff and medical equipment to support air ambulance operations.

Given how vital such services are, it is not surprising that our electors—the public—are keen to see them funded by the Government as part of the NHS. Having listened to the sector, however, our view remains that the charitable model for air ambulances remains the right one—a view that, as I say, is shared by the sector’s independent professional body, Air Ambulances UK. That model has been a long-standing success; London’s Air Ambulance was established as a charity as far back as 1989, and I believe it has now helped more than 40,000 patients.

Decisions on the provision of services for the safe delivery of care are best made at local level. Maintaining a charitable model gives charities and the air ambulance the independence they need, as I alluded to in the earlier quotes, to deliver specialised services tailored to the needs of patients in each locality. A charitable model is also, in many ways, a more feasible way to fund the high capital and revenue costs associated with helicopter emergency medical services, including purchasing and maintaining helicopters. It also gives charities the independence to raise funds through commercial activity and sponsorship with their commercial partners.

Before the pandemic struck, I had the privilege of visiting and—for a brief period—helping in the Birstall air ambulance shop in my constituency, which supports the Derbyshire, Leicestershire and Rutland Air Ambulance service. It would be remiss of me not to take the opportunity to put on record my gratitude to it, as my local air ambulance service, for the amazing work it does, day in and day out, across that part of the east midlands. Indeed, even during the pandemic last year, two new helicopters were delivered to help to support that service. I believe it is the only air ambulance service that delivers a children’s air ambulance service. Let me put on record my gratitude for and recognition of the amazing work it does.

I believe, and the charities believe, that the current model still represents the best route to funding our air ambulances—those cherished institutions—because it gives them local flexibility to do what they need to do. In future, we want to build on the success of air ambulance services and their contribution to the delivery of safe and effective care to the nation. As part of transforming how urgent and emergency care operates, NHS England and NHS Improvement have been working with ambulance services on new ways to deliver care to patients. For example, rather than conveying all patients to hospitals, ambulance services are developing new ways to give healthcare advice through video consultations and by referring patients to a greater number of services in primary care in the community. As we move to a new model of integrated care, each system will have the duty to collaborate with health and care organisations in their local area, including considering how air ambulances can best contribute to their network of urgent and emergency care services.

Essential public donations combined with significant funding contributions from Government—be it for capital or in extremis, as we saw during the covid pandemic—will ensure that the air ambulance charities can continue to provide their world-class care for a patient-centred approach that works for the population they serve. Both the Government and Air Ambulances UK strongly believe that that is best achieved through a charitable model. I encourage everyone to support their local air ambulance charities, even if I do not give in to the gentle temptation offered by the shadow Minister to run the London marathon.

During these unprecedented times, I reiterate my unreserved thanks, and the thanks of all hon. Members who spoke and from across the House, to the staff at the air ambulance charities for continuing to provide their world-leading, life-saving care to patients and their local communities across the UK. They are genuinely inspirational to us all. There is a reason why so many people donate so generously to their air ambulance charities: they know that one day, they could be the one who needs that air ambulance. I suspect that across the country, there is the same huge admiration and gratitude for the fantastic work that these charities do every day.