Accident and Emergency

Debate between Tom Blenkinsop and Lord Watts

Wednesday 18th December 2013 Commons Chamber

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

I wish to discuss two topics. First, I want to raise the issue of funding for the North East Ambulance Service NHS trust, the rising use and cost of private ambulances and other ambulance pressures, and, secondly, I want to raise with the Minister the ongoing Monitor investigations into the two foundation trusts, that serve my constituents, the South Tees Hospitals NHS Foundation Trust and the Tees, Esk and Wear Valleys NHS Foundation Trust.

Over the past 18 months, the A and E department at the James Cook university hospital, which serves my constituency, has come under considerable pressure. In particular, in the run-up to last winter, there were problems with handover times, with ambulances and paramedics waiting up to two and a half hours to admit patients, despite the national target time being 15 minutes. I raised this matter last year with the Secretary of State for Health, who agreed that the situation was completely unacceptable, and with the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter),in a Westminster Hall debate on A and E provision in the north-east on 13 February 2013.

In addition to the issues I raised with the Secretary of State, it became evident that James Cook’s A and E department struggled to manage with the pressure that winter placed on it. In January and February, South Tees Hospitals NHS Foundation Trust failed to meet its target of seeing 95% of A and E patients within four hours. With James Cook so clearly overstretched, I was surprised to discover in September that the Secretary of State decided not to award it, or any other hospital trust in the north-east, funding to alleviate pressures on A and E. It struck me as beyond belief that of the £250 million he awarded to 53 trusts, not a penny was to reach the north-east. Thankfully, following pressure from the Opposition, including in my Westminster Hall debate on north-east NHS services on 5 November, the South Tees trust is to receive £2.1 million, as announced earlier this month.

For weeks and weeks, however, I have received recurrent expressions of concern about the increasing use of private and voluntary ambulances in response to 999 calls in my constituency. I wrote to the North East ambulance service about two of these incidents. From its reply, it became clear that central Government funding cuts were eroding the blue-light service. It wrote:

“Each year we have discussions with our commissioners on the forecast number of incidents in the forthcoming year. The outcomes of these discussions for 2013-14 were that commissioners felt it necessary to set our income on activity for the next 12 months at a level less than we were forecasting... So for 2013-14, we have been contracted to respond to 376,000 incidents, although we are forecasting activity at an estimated 415,000. This means that any incidents above 376,000 will be funded on a one-off basis rather than as recurrent annual income. These arrangements do not allow us to enhance our own workforce plan because the money for the additional activity will not be available next year to fund the extra salaries”.

[Mr Dave Watts (St Helens North) (Lab)]

Is there not an element almost of secrecy taking over the NHS, with trusts not allowed to talk to MPs or tell them the facts and trusts’ financial details not being published? Does my hon. Friend agree that that is not healthy for the NHS?

[Tom Blenkinsop]

For that reason, I had to put in a freedom of information request to the trust to get the information I shall now detail.

According to that letter, our ambulance service will see more cuts, more private ambulances and possibly a less responsive service. It is not me saying this, but the chief operating officer of the North East Ambulance Service. In 2008-09, private ambulances attended 865 call-outs in our region, costing £86,118. In 2009-10, there were 1,816 call-outs, costing £151,112. In 2010-11, however, there were 6,429 such call-outs, costing £477,575. In 2011-12, there were 9,034 of these call-outs, costing £639,819, and in 2012-13, there were 13,524 call-outs of private and voluntary ambulances, costing £754,461. Since Labour left office, therefore, a fivefold cost increase in private ambulances has occurred in the north-east—these are funds going to private contract firms. It is obvious that from 2010 onwards an explosion of private ambulance usage by the trust has occurred, costing a huge amount of taxpayer funds. As the chief executive states:

“These arrangements do not allow us to enhance our own workforce plan because the money for the additional activity will not be available next year to fund the extra salaries, overheads and vehicles we need to meet the extra demand.”

The police and crime commissioner for Cleveland, Barry Coppinger, has said:

“The bottom line is that police officers are not medical professionals and should not be put in the position of having to transport patients to hospital. Police vehicles are unsuitable and unequipped; it not only puts undue stress on the patient, but also the officer who should be able to continue to fulfil policing duties on the ground… The downward trend in incidents from September to October relates to a policy change by senior officers”—

not the NHS—

“within the Force and a directive issued that officers should not transport patients to hospital unless there is an immediate risk to life. However, there have been five occasions in November of officers being forced to take patients for urgent medical treatment due to ambulance delays.”

I hope for a response from the Secretary of State or a Health Minister. I would be more than willing to talk to them about this subject, because it is a massive concern, particularly in the east Cleveland part of my constituency.