Ambulance Response Times

Lord Scriven Excerpts

Tuesday 1st February 2022 Lords Chamber

[Lord Scriven (LD)]

I declare my interest as a non-executive director of Chesterfield Royal Hospital NHS Foundation Trust. I too welcome the Minister back to the Front Bench. I hope that this first outing is not as difficult as the last set of amendments was for her noble friend Lady Williams.

I thank my noble friend Lady Barker for securing this debate, which is important and necessary, considering the issues that many people and communities face with their ambulance services at present. This is despite the dedicated professionalism of so many people who work to try to save lives and deal with some of the most vulnerable people. Rather, it is a reflection of the way in which our healthcare system is struggling to meet the demands of the population it serves.

This debate must not be about just statistics but people—those who require the services of the ambulance service and those many thousands of individuals who work for the ambulance service and do their best in providing professional first response and medical services when people are in their greatest need. I want to bring to the attention of the House one such family and the distressing phone call a man in his 20s had to make when he woke up and found his mother struggling for breath. In that call, he can be heard telling ambulance call handlers that his mother, from Ashton-under-Lyne in Greater Manchester, was struggling to breathe after she woke up screaming his name in the early hours of the morning. He describes how her situation is critical, only to be told that he may well have to wait for one and a half hours for an ambulance to arrive because the service is busy.

The man rings back later and says that his mother’s mouth has gone white and pleads for immediate assistance, but emergency service personnel can tell him only that help is on the way. Another call is made after his mother collapses and becomes unresponsive. Her heartbroken son can be heard venting his anger that an ambulance did not arrive in time to save her. He tells the call handlers, “I rang an hour ago for an ambulance. She’s had difficulty breathing, and now she’s dead. My mother is dead.” When paramedics finally arrived at nearly 3.30 am, almost an hour after his initial call, they tried to revive his mum but attempts, sadly, failed. Unfortunately, this is not a one-off tragic event but is happening to many families across the country.

Therefore, I ask the Minister what she would say, on a human level, to those families who see a loved one die or see serious health implications for members of their family when an ambulance does not arrive. We must not hide behind statistics: these are real people and the effect of not having an effective ambulance service is that people are dying and families are shattered.

This debate is not about a quick fix for the ambulance service but indicates that the Government must move to a more person-centred approach to the care system. It is no good looking at why ambulances are not able to respond speedily without dealing with why they have to wait up to 10 hours outside hospital admissions doors because people in A&E cannot move into a hospital bed as 10% to 30% of those beds are occupied by people who are medically fit to be discharged but do not have a care package in place, so they cannot be discharged out of the discharge door of the hospital.

Just putting more money into the ambulance service, as welcome as that is, will not solve this crisis in a sustainable way. A key question around this systematic issue is: when are the Government going to bring forward well-thought-out and fully costed long-term plans to deal with the social care issues that keep over half a million bed days a year blocked due to people not being able to move when they are ready for medical discharge?

Another knock-on effect, which would help solve the ambulance crisis, is caused by the problems in general practice. The Government know that many GPs feel burned out and are working incredibly long hours, but many are retiring because of the workload. General practice is becoming the first port of call for many medical and social problems. When people find it hard to get a GP’s appointment in a timely manner, they ring the ambulance service, knowing that they will receive some form of medical intervention. So the question is: what are the plans for dealing with GP services so that people can get a timely appointment and GPs do not feel that they have to retire because their work/life balance is not in kilter?

The University of Sheffield, in March 2020, produced a very good paper: Reducing Avoidable Ambulance Conveyancing in England: Interventions and Associated Evidence. That paper comes up with many solutions, and a lot of them are about integration, which my noble friend Lady Barker talked about. I will ask some questions. If we are seriously talking about intervention, what is the Government’s thinking about doing away with individual ambulance trusts? Why are they not part of health provider trusts so the innovation can come and the walls between those who are part of first responder services in health and those who provide care services are removed and they are integrated rather than seen as separate legal entities? Would the Government be open to that kind of integration and to saying that it does not have to be a separate ambulance trust?

What is the Government’s working—particularly in line with that paper from the University of Sheffield—on mental health issues? The evidence shows that quite a lot of the conveyancing of people with mental health issues via an ambulance took place only because there were not community services for those suffering from mental health issues. Where is the investment? Where is the government thinking on that? This is not an ambulance crisis but an issue to do with our health service not being able to meet demand or not being prepared for dealing with the requirements of the modern healthcare system.

These issues will take time, so there has to be a much more immediate response. It is clear that the £55 million that the Government introduced in July is not enough to tackle the problems. So, finally, let me ask the Minister: what plans above the £55 million do the Government have, and when will they be implemented, to ensure that in the interim enough staff, ambulances, equipment and expertise are available for responding paramedics so that no one else has to make a heart-wrenching phone call that ends with a loved one dying, as the young man in Greater Manchester had to do, seeing his mum take her last breath because an ambulance was not able to get to them in time?