VAT on Air Ambulance Fuel Payments

Mary Macleod Excerpts

Wednesday 11th July 2012 Commons Chamber

[Tracey Crouch (Chatham and Aylesford) (Con)]

I start by congratulating my hon. Friend the Member for Hexham (Guy Opperman) and the hon. Member for York Central (Hugh Bayley) on securing the debate. I was delighted to attend the Backbench Business Committee meeting at which the proposal was made. I know that the hon. Member for York Central was unable to be there, but I am pleased that we now have the opportunity to have this discussion in the Chamber. I want to make a short contribution in support of the motion.

The Kent, Surrey and Sussex Air Ambulance has a special place in the hearts of my constituents. It provides an invaluable service across the three counties, which have seven motorways running through them on which five serious accidents happen every day. However, road accidents account for only 41% of the emergencies that the local air ambulance attends. Medical emergencies such as cardiac arrests and strokes account for a further 25%, and both require a swift response and excellent, quick medical care if they are to be dealt with quickly and properly.

A quick news search on the Kent, Surrey and Sussex Air Ambulance shows how vital it is across the counties. Yesterday, it landed on the M20 motorway and took a lady who had fallen from a bridge not to the hospital at the next junction but to a specialist unit in London. A few hours later, it transferred from Ramsgate to King’s college hospital, again in London, a workman who had fallen 30 feet. That journey would have been very difficult to make by road. Last Friday, the helicopter took a 78-year-old man with serious facial injuries following a DIY accident from Lordswood in my constituency to hospital in London. As the local newspaper reported, the helicopter landed nearby at 10.25 am. Doctors gave the man emergency treatment at the scene before he was flown to the major trauma centre at the hospital in Denmark Hill.

[Mary Macleod (Brentford and Isleworth) (Con)]

This is a crucial issue, because the VAT money could be put back into the air ambulance, especially the London air ambulance, which serves more than 10 million people. We need a second air ambulance to serve those numbers.

[Tracey Crouch]

I completely agree. The Kent, Surrey and Sussex Air Ambulance has two helicopters to serve the three counties. I am sure that all money saved from VAT would be used effectively.

One great thing about the Kent, Surrey and Sussex Air Ambulance is that it transports a specialist doctor and a critical care paramedic directly to the scene of serious medical emergencies. They provide enhanced care at the scene of the accident, often involving medical procedures usually provided only in the emergency department of a hospital. Patients are flown to the most appropriate hospital for their needs, and many are transferred to county or regional hospitals. However, as the three shouts I described show, patients quite often require specialist treatment at a major trauma centre in London. Quite simply, the intervention of the air ambulance team saves lives.

The Kent, Surrey and Sussex Air Ambulance costs £5 million per year to fund and operates 365 days a year, responding to 1,500 to 1,800 medical emergencies per annum. It is funded almost entirely by donations. Its mission, objective and outcomes are as important to our country as those of the Royal National Lifeboat Institution, another lifesaving service very dear to my heart. However, as we have heard, and as the motion states, the key difference between the two is that the air ambulance pays VAT at the rate of 20% at its base in Marden. It buys fuel in bulk and uses between 180,000 and 200,000 litres a year. Given that each mission costs around £2,500, zero-rating fuel for the helicopters would save the air ambulance a significant amount of money that it could reinvest in its life-saving functions. That is not a vast amount of money for the Treasury, but it would be directly available to air ambulances.

It has already been made clear that, under EU law, it is not possible to implement a new zero-rating into UK legislation relating solely to the air ambulance. Although I am not a VAT expert, let me offer the Minister a possible solution. Schedule 8 to the Value Added Tax Act 1994 refers to charities and outlines provisions that allow for the supply, at the zero rate of VAT,

“of any relevant goods to an eligible body which pays for them with funds provided by a charity”.

The Act also makes it clear that “relevant goods” includes “ambulances” and

“parts or accessories for use in or with”

ambulances. Her Majesty’s Revenue and Customs already accepts that “ambulances” includes specially equipped air ambulances or watercraft, and that “eligible bodies” includes charitable institutions providing

“rescue or first aid services”.

Under those provisions, therefore, and with guidance from the Treasury and HMRC, the air ambulance could purchase fuel in its own name for use at a zero rate of VAT. I am sure that, with proper discussion, air ambulance charities could certify the use of the fuel, making them liable for VAT payments if they misappropriate it for other purposes. Furthermore, I am sure the charities would be willing to appease any concerns that HMRC might have on claims for retrospective recovery of VAT incurred over the past four years, which would obviously lead to a greater cost to the Treasury.

The Treasury might be concerned about the reduction of revenue, but it should recognise how much the air ambulance saves the NHS. First, like others, the Kent air ambulance is not funded by the ambulance service or the NHS. Secondly, the speed at which it can transfer injured persons to hospital often means that they are treated and discharged more quickly, thereby saving the NHS money in the long term.

Throughout the debate thus far, Members have spoken highly of the air ambulances serving their constituents. There can be no doubt about the level of genuine support they enjoy, but as the motion makes clear, and as we have heard, there is potential for the Treasury to give additional financial support to help air ambulances up and down the country to carry on providing a vital service. It is for this reason that I urge the Treasury to review the current VAT arrangements and use this opportunity to recognise further the vital contribution that the air ambulance service makes to people’s lives.

--- Later in debate ---

[Mary Macleod]

I applaud the hon. Lady’s enthusiasm for the London air ambulance service, which I share. The service is also supporting the Olympics and the Paralympics, on top of its normal work load, serving and supporting so many individuals—more than 10 million within the M25—as compared with many other air ambulances, which support far fewer people.

[Rushanara Ali]

I could not agree more with the hon. Lady. She has been working with me to highlight the work of the London air ambulance service. I will talk about the demands in the run-up to, and during, the Olympics in a moment.

The London air ambulance service has a doctor-led team that provides advanced medical procedures and leadership in situations in which a patient might otherwise die before reaching hospital. As London’s only helicopter medical emergency service, the team works incredibly hard to provide 24/7 emergency care services to the 10 million people who live and work in the capital.

Despite the incredible work of the London service, its funding is limited. Many people do not realise that it is a charity, as are many of the other air ambulance services around the country. At a time when it should be expanding its operational capacity, a lack of funding means that it is unable to do so. That will have an impact across London, and, as the hon. Member for Brentford and Isleworth (Mary Macleod) has mentioned, that is deeply worrying in a year in which millions of visitors will come to the city for the Olympics.

Compared with other cities in England and Wales and around the world, London’s air ambulance service lacks resources. It has just one helicopter and one team to serve 10 million people, compared with an average of one helicopter per 1.5 million people across the rest of the UK. Internationally, Paris has 12 teams and at least three helicopters, and Sydney has six helicopters.

London’s air ambulance service is currently funded through private donations and an NHS contribution, but much more work must be done to raise funds if it is to provide the level of service required to meet London’s growing needs. In these tough economic times, it is even more challenging for the service to achieve its funding objectives. As a charity, it relies heavily on donations from the corporate sector, and in 2011 donations and sponsorship made up 45% of the service’s overall income. The donations from organisations, charities and companies are welcome, and donors include organisations such as Virgin, Coutts and the London stock exchange. At a time of economic uncertainty, however, that funding is not stable, and it does not meet the funding needs of the service.

Contributions from the private and corporate sectors play a large part, but it is vital that the Government should meet their obligations to support the charity. The London service has received a long-standing donation of £1.2 million from the NHS, which represented 40% of its overall income in 2011, but I believe that the Government must do more. The impact of the Government’s VAT increase to 20% is being felt by services such as London Air Ambulance, which receives no support to cover the cost of VAT on aviation fuel payments. We are calling on the Government temporarily to reduce the rate of VAT from 20% to 17.5%, which would lessen the VAT bill for charities, including air ambulance services.

The London air ambulance service needs an estimated £3.9 million if it is to enhance and expand the service that it provides in the coming years. The necessity for the service to do that will only increase, and it is important that we take action now to ensure that the service can cope with future demand. The extra funding would enable the service to acquire and maintain a new helicopter in order to achieve 100% “up time”, so that if one helicopter required maintenance, another would still be operational. It would also allow the service to maintain medical and rescue equipment, fund medical innovation and invest in staff training, research and the charity’s infrastructure. That type of expansion would greatly enhance the service, benefiting Londoners and ensuring a sustainable model for the future.

The London Air Ambulance is a service that many of us take for granted. It is a service that many of us do not think of as a charity, and one that we would expect to assist us in an emergency. This is a call to the Government to reduce VAT to 17.5% and give charities such as London’s air ambulance service the support that they need. It is also a call to the private sector and the business community, in London and elsewhere, to invest in the air ambulance services and support their incredible work of saving people’s lives.