Health Bill

Lord Scriven Excerpts

Committee stage
Wednesday 11th November 2026 Lords Chamber

[Baroness Coffey (Con)]

My Lords, we have got a Holy Trinity now. We have dealt with how we encourage people to get into and stay in work, we have talked about dentistry, and now we are going to talk about more things to do with urgent care.

This amendment is about promoting equitable access to ambulance services. I feel passionately about this: it was something I dedicated a lot of my time to as an MP, trying to improve access at local level. It was when I learned about how often, on a regional basis, we would see actual manipulation of where ambulances were placed in order to make sure targets were hit—but it did not mean that patients were served well.

There are a number of issues in regard to ambulances, and I pay tribute to many first responders. In the statistics, recorded nationally, a volunteer responder turning up is the same as having a paramedic arrive. In the East of England Ambulance Service, which had started to show improvement but is now really struggling —again—ambulances are quite regularly sent without any qualified paramedics in them.

I come back to the point that this situation can be very serious. Quite often, outside our major cities, for example in the east of England, if you have a stroke or a serious heart issue, you have to go to Cambridge for the best treatment. Stuff has happened along the way to try to make sure that you can stop en route, in places such as Ipswich and Norwich, in order to get something along the way. A stroke is something that causes the greatest harm, in terms of people having a good quality of life later. Of course, having a wide range of first responders across the country is a very useful way to help people who have had either a cardiac arrest or a heart attack, to keep them alive. But the difference in your quality of life depends on how quickly you get treatment when you have had a stroke; it is a real life changer.

One of the things I am conscious of is that we have many rural areas around the country. Something more needs to be done to help rural communities. It also happens to be the case—particularly thinking of coastal areas—that a lot of tourists rely on emergency services when they are on holiday. That is not taken into account in some of the funding measures, as far as I am aware.

I am pleased that we have seen an increase in the number of paramedics, but, reflecting on the point referred to earlier by the noble Baroness, Lady Hollins, on clinical staff in the NHS, it is paramedics who have the highest sickness rates. I think it is more than double —perhaps even treble—how often an average hospital doctor or consultant sadly ends up being off ill. It is not the Cinderella of the NHS, but it is certainly a part of the service that has been forced into mergers over the years, and there is huge reluctance among NHS leaders to break them apart in a way that would perhaps help patients. Indeed, we are effectively seeing many more mergers happening around England, which is going to be a real struggle, particularly for rural communities.

I am grateful to the Minister for sending the letter today about what will be happening. ICBs are taking on dentistry as part of their statutory duties, but there was no reference to what would be happening with ambulance services. I know it is common practice that one ICB tends to do the commissioning on behalf of all ICBs in that area, because they are currently constrained by the fact that they do not have any choice in where they get their ambulance service. I am not suggesting that we go for some free-market approach. We need a sensible, well-connected way of dealing with these emergencies. It would be useful to hear what the Secretary of State’s plans are for the next phase of NHS provision across the country.

I share the concerns, reflected in other amendments in this group, about people suffering corridor care. I look forward to trying to better understand the amendment from the noble Baroness, Lady Pidgeon, regarding 12-hour admissions to A&E. It has become terrible how patients are not being seen, especially when that can be a matter of life and death. I hope that we will have some further useful discussions on this important blue-light service and recognise the contributions made by paramedics and community first responders right across our country. I beg to move.

[Lord Scriven (LD)]

I know the noble Baroness likes to be absolutely correct. She said that the highest rate of NHS staff sickness was among ambulance paramedics. It is actually ambulance support staff, which does not include paramedics. I am sure she would like to correct the record.

[Baroness Coffey (Con)]

I am grateful to the noble Lord for doing that. That is not in the information that I have, but I completely accept what he has said. It is unusual in the NHS that the average number of sickness days lost to non-clinical staff is more than double that to clinical staff, but I completely understand the noble Lord’s point.

--- Later in debate ---

[Baroness Merron (Lab)]

I take very seriously the point that the noble Baroness made. I am sure it is already being looked into, but I will personally make sure that that is the case.

On corridor care and children, one example of the practical action taken is our recent announcement that the NHS is rolling out a standardised system to spot when a child’s health is deteriorating, so that early warning signs are caught earlier and there is faster action. The paediatric early warning system will be introduced in all emergency departments by the end of 2027-28, with an ambition to also roll this out in ambulance and community settings in the future. This is broader than just corridor care, but I know that that is a particular concern, as I said, when it comes to children. I cannot confirm often enough that we remain committed to fully eliminating corridor care before the end of this Parliament.

Finally, on Amendment 72, in the name of the noble Lord, Lord Patel of Bradford, I can give the reassurance that there is no national policy supporting blanket minimum waits. Indeed, patient safety always comes first. If a commissioner puts capacity measures in place, urgent referrals must be excluded, minimum waits must not be set above 18 weeks and providers must continue to triage patients according to clinical priority.

At the start of the year, it is important and expected that commissioners plan to balance service delivery with their yearly budgets while prioritising patient safety and clinical need. I remind your Lordships’ House that it is due to our approach to financial planning that the NHS stayed in line with its budget in 2025-26 while also cutting waiting lists by over 250,000 between July 2024 and August 2026. Removing the use of tools to support planning could drive unplanned activity and overspending, which would of course undesirably divert resources from other patients.

On the points made by the noble Lord, Lord Patel, about autism and ADHD assessment, expectations have already been set out for ICBs and providers to reduce those long waits and to improve experience, quality and productivity in ADHD services over the next three years. We are moving to a needs-led support model that means earlier access to information and support and appropriate interventions that are individually based, without and before a diagnosis.

On the question about ICBs imposing minimum waits and whether we will publish which ICBs are doing this, there are no plans to publish this information. The data is held locally and that is right, because these are decisions for local areas. To restate what I said before, commissioning decisions are for ICBs to make.

[Lord Scriven (LD)]

The Minister just made a very important point. Can she clarify? Is she saying that there is a requirement for ICBs to statutorily report that they have implemented a minimum wait standard, or not?