HC Deb 12 June 1947 vol 438 cc1364-8
Mr. Grimston

I beg to move, in page 4, line 25, at the end, to insert: (f) to employ the fire brigade if requested so to do by the Health Committee of the local authority in running the local authority's accident ambulance service and in that event to have full responsibility for that service. I do so chiefly to find out the present position with regard to this matter, having regard to the discussion which we had in Committee on the running by the fire brigade of the accident ambulance service if requested to do so by the health committee. During our discussion in Committee the Home Secretary said that the spirit of the Amendment was accepted, and that between then and the Report stage he would look into the question of making an appropriate Amendment to the Bill.

Under Clause 3 (1, e) the powers of the fire authority are to include power to call up the fire brigade maintained by them for purposes other than fire-fighting. Subsection (3) provides that before making any standing arrangements for the exercise of powers conferred by that paragraph, they shall obtain the approval of the Secretary of State to the proposed arrangements. That would cover the provision of ambulance services by the fire authority. In Committee we were all agreed that it was desirable, because in many cases it led to speed and economy in manpower, that the ambulance services should be run by the fire authority. That being so, it seems to us that, where it is desired by the local authority, they should be able to do it under the terms of the Bill without having to refer the matter to the Secretary of State. As I say, the right hon. Gentleman promised that he would consider this matter. He accepted the principle of the Amendment and I now give him the opportunity of telling us how the matter stands.

Mr. Rees-Williams (Croydon, South)

I wish to support the Amendment. I had some correspondence with the Home Secretary some months ago on this point, when the Bill was first printed. In my area, when we ran our own fire brigade, we found it most convenient to have the fire brigade also running the ambulance service. It was also an economy I agree that the case is probably covered by Clause 3 (1, e) but I ask the Home Secretary to make this point clear beyond any shadow of doubt.

Mr. Ede

I am grateful to hon. Members for raising this matter again. Since we had the discussion upstairs, I have had further negotiations with the Association of Municipal Corporations and the County Councils Association, and also with my right hon. Friend the Minister of Health, whose Department will also be involved, as the ambulance services are part of the health services. Simultaneously, the Ministry of Health have been engaged in negotiations on these matters with those associations. I think all parties are anxious that there shall be economy of manpower and appliances, and also economy in the giving of Governmental consent which I regard as quite as important as the other objects.

In the consultations which have taken place between the Minister of Health and myself, there has been general agreement that these two services should be combined, but we have not yet reached complete agreement as to the precise form which the combination should take. My right hon. Friend the Minister of Health is issuing to local authorities a circular under Section 20 of the National Health Service Act in which he will ask that the proposals of national health authorities in regard to ambulances shall be submitted to him for approval by the 30th of this month. When he receives those schemes, he will go into them, and my Department will also be consulted. I do not expect that the final arrangements will be the same in every area. There will be some areas where there are no local fire stations with firemen continuously employed, and it may be that a very different arrangement may have to be made there from that in the county borough represented so ably by my hon. Friend the Member for South Croydon (Mr. Rees-Williams). I have no doubt we shall find that the arrangements will vary.

The primary responsibility for the ambulance services rests on my right hon. Friend the Minister of Health. We hope that it will be possible in the great majority of cases to arrange that the fire services personnel will be available to drive and to man the ambulances. In order to avoid duplication of consent, I am proposing at at a later stage this afternoon, in an Amendment to Clause 3, page 4, line 45, to add at the end, with regard to these standing arrangements that they shall obtain the approval of the Secretary of State to the proposed arrangement: unless they have been approved by the Minister in charge of any other Government Department. That will mean that if the Minister of Health gives his sanction to any scheme of amalgamating the fire brigade and ambulance service, it will not be necessary for a separate approach to be made to my Department, and a second consent to be sought. Of course it will be arranged that before he gives his consent in any case he will notify me that he proposes to do so. I hope that hon. Members will feel that the explanation I have given enables the existing machinery in the Bill to operate so that duplication will be avoided, and that in the circumstances the Amendment is unnecessary.

Mr. Sidney Marshall (Sutton and Cheam)

There is a distinction in the ambulance services. This Amendment applies particularly to accident ambulances, which provide quite a different service in many respects from the full ambulance service which is to be operated under the Health Services Act by the county authorities. That has no need to be associated so closely with the fire service. Whatever arrangement is come to, it should be understood that powers will be given to have them carried out by the fire service quite distinct from the ordinary ambulance service which hospitals employ, and which is not required for the same emergency need as accidents.

Colonel Wheatley

As the Minister explained, we cannot lay down any absolute rule for a local authority because they are not all the same. As my hon. Friend the Member for Sutton and Cheam (Mr. S. Marshall) described, the hospitals have an ambulance service, but in many cases hospitals are dependent on the town ambulance service. The Minister's suggestion carries out what we want in this Amendment. He realises that we cannot lay down any definite regulations for every ambulance service throughout the country.

Mr. Ede

I have been associated with the hon. Member for Sutton and Cheam {Mr. S. Marshall) in the government of Surrey for many years, and it is something new for me to be replying at this Box to the chairman of Surrey County Council. Many people have replied to me from this Box, and now I begin to understand how comfortable a feeling it is to reply to a chairman of a county council. The point made by the hon. and gallant Member for East Dorset (Colonel Wheatley) should be borne in mind. My hon. Friend the Member for South Croydon (Mr. Rees-Williams) spoke in regard to a county borough, and the hon. Member for Sutton and Cheam speaks for a county which is considerably, but not completely urbanised. The hon. and gallant Member for East Dorset has spoken for a county that is even less urbanised than Surrey, though part of his constituency, the borough of Poole, is itself fully urbanised. It would be very difficult indeed to put into the Bill words which would enable us to cover the elastic kind of arrangement that must be made to deal with such diverse conditions. I hope the words which I propose to insert in page 4 will prevent duplication of applications to Government Departments, and I hope that the general words in the Bill, in the light of the negotiations which we have had with the local authority associations, and with the Ministry of Health, will enable us to meet all the points that have been raised in the discussion this afternoon.

4.30 p.m.

Mr. Grimston

I am obliged to the right hon. Gentleman for his response. I presume that it any points occur in reply to the circular which is going out from the Ministry of Health, opportunity will occur in another place to embody anything that is necessary. It seems to me that the Amendment which the right hon. Gentleman proposes to introduce later covers the point which we have in mind, and in the circumstances I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause ordered to stand part of the Bill.