Ambulance Services (Guisborough) (Hansard, 4 March 1986)

§ Mr. Richard Holt (Langbaurgh)
I welcome this opportunity to speak in an Adjournment debate at an early hour, because on the previous occasion it was at 4 am. My subject matter is much more serious tonight, because this is the last stop for an elected representative to try to redress the position of ambulance services in his constituency.
"Where is Langbaurgh?" is a kind of music hall joke. When I tell people that it is in Cleveland, they ask, "Where is Cleveland?" It is no joke to my constituents to find that the ambulance service which has served the heart of the constituency for many years has been altered by a decision by the area health authority. A couple of years ago the ambulance authorities decided that a report on ambulance services in east Cleveland would be prepared by the health operational research unit. HORU is a respectable and eminent body. It bases its researches on years of study in various parts of Britain. It puts all the information through a computer, which spews out answers at the end. As we all know, computers are capable of producing answers based only on the information put into them. If one fails to put in information about the topography, the weather or the disposition of the population, the answers are liable to be distorted, if they are based on a standard format.
The result of the action of the area health authority, acting on the recommendation of the local ambulance service managers, is that, to all intents and purposes, the Guisborough ambulance station has been closed. It is unusual in political life to find an issue on which all sectors of the community—religious, political and academic—are united. They all say in this case that the area health authority was wrong to make this change. Nobody can deny that the authority's criteria met the specifications of the Department. Indeed, those criteria went beyond the rural and into the metropolitan, specifications. This is a domestic matter affecting the south Cleveland area.
It may be argued that monetary savings are involved and that that must be for the good of the community. In this case, not only is it questionable whether there will be any savings, but I could adduce evidence to show that what is proposed will be more expensive. Either way we need not spend time trying to put a monetary value on people's lives.
The case that I make tonight is based on local knowledge of events in the last 12 months and the strong feeling of the local community that a wrong has been perpetrated. We have nobody but the Government to whom to turn to bring pressure on the area health authority, even at this late stage. to change its mind.
The initial recommendation was that the Guisborough ambulance station should close. That would have meant my constituents living near the north Yorkshire border being denied an important section of emergency ambulance provision. Bowing to public opinion, the local ambulance management had second thoughts and, instead of closing the Guisborough station, kept it open for 22 of every 24 hours by having on hand an ambulance and crew from Redcar.
The result is that there has been no cost saving, and a well-established station, its appliances and crews have been dispersed. Every day an ambulance crew travels half 286 an hour from Redcar to Guisborough. Later, it travels back to Redcar, and then another ambulance does the round journey. Thus, for two hours a day ambulances and crews are travelling between the two areas. For 22 hours a day, a strange crew from Redcar waits in Guisborough to answer emergency calls.
The logic of this has been lost on everyone, apart from the management and the area health authority. The service that is provided to my constituents has been diminished. That diminution goes beyond my constituency, into those of my right hon. and learned Friend the Member for Richmond, Yorks (Mr. Brittan) and of my hon. Friend the Member for Scarborough (Sir. M. Shaw), for the ambulance services go to many of the small and outpost villages in the north Yorkshire area that are frequently cut off by adverse weather conditions, when the roads are impassable. These are the people who are most likely to be at risk.
An analysis of accident statistics in the area shows that the vast majority of road accidents occur on the fast moors road between Guisborough and Whitby. By definition, it will take longer for an ambulance crew to arrive at the scene of an accident than has hitherto been the case. There can be no justification for this.
Worse still is an analysis of the actions of the area health authority. It produced a plan to close the station, NA 111C h it then amended. Although the area health authority was supposed to take into consideration the views of all the people in the area, it admitted to what it called "a word processing error." The views of three of the parish and town councils adjacent to Guisborough were not presented at the meeting when the decision was taken. The voices of three important local community councils were not heard.
If there is a case for the alterations which have been made, it centres on a new ambulance station at Coulby Newham, at the western end of my constituency. This was commissioned and built at a time when the extrapolation of population growth was greater than that which has come about. The ambulance authorities were therefore faced with the embarrassment of a new building for which they had no use. They have justified its use by making it operational and by closing down, to all intents and purposes, the emergency service and cover in Guisborough.
Why is Guisborough so special? With a population of just under 20,000 it is the major town in my constituency. If one visited Guisborough, one would see, standing in a row in the same road, the police station, the fire station, the hospital, the Territorial Army barracks and the ambulance station, all within 200 yds of each other. What have the authorities done? They have closed the ambulance station. If there is an accident to which the fire engines and the police are called, they look around to see whether an ambulance will join them, or they hope that an ambulance will come to join them from Redcar or Carlin How. This cannot be right.
All my constituents have been to see me and have prevailed upon me to raise this matter in Parliament. It is their last hope that common sense and pressure can be brought to bear upon those who were responsible for making this decision. The shop stewards at the ambulance station are concerned. In case there are those who might suggest that this is a political intrigue, I must advise everyone that the ambulance service in Guisborough includes a Conservative councillor whose mother is also 287 a Conservative councillor for the town of Guisborough. In the political context, therefore, there is no divide. The new management of the ambulance authority is determined to make the change and to implement the health operational research unit recommendations, irrespective of the views and wishes of the populace.
Public meetings have been held, at the end of which no one was satisfied with the explanations given by the chief ambulance officer to justify the proposed changes. There have also been private meetings of the chambers of trade, Rotary and others concerned in the town. No one is in favour of the alteration, other than the management. Management admits that when it reached its conclusions it did not have all the evidence. It did not have the information which had been missed by the word processor and/or the computer. There is great strength of feeling that the very latest that could be done is for the Govenrment to write to the area health authority asking it to reconsider the view that has prevailed so far.
Some may ask why I have not been supported in my endeavours by other hon. Members in the Cleveland area. They are not supporting me because all of them are getting a better deal out of what the area health authority is bringing into practice. Therefore, I do not blame them for not supporting me. If I were the Member of Parliament for an area that was getting improved ambulance cover I would be grateful. But when one is left on one's own, one's resolve and strength of feeling become greater. It would have been more honest if other hon. Members from the Cleveland area had had the courage to support me in my long and sustained battle over the past 12 months against the area health authority.
There is no element of cost saving or of a cutting exercise. All too frequently people claim erroneously that the reason for Government action is that cuts are being made. That is not the case with the ambulance services in east Cleveland. The alteration is intended to improve the service. For one third of the area that will be the case, but for two thirds of the area—the larger geographical but the smaller numerically—that will be far from true.
I hope my hon. Friend will accept that there is no criticism of the Government and no intention to make play of cost cutting. The decision is wrong. It was made on ill-founded theoretical grounds. I do not want to be responsible for anyone having to tell a newly bereaved widow or mother that her husband or child has died because the ambulance service they had enjoyed has been taken away. That is what we are facing in east Cleveland. There can be no solace in that for anybody.
It is all very well to say that one is arguing about a difference of seven, eight, 10 or 11 minutes, but one is also arguing about a lost camaraderie which had been engendered within the ambulance station. In the community sense, the ambulance service is responsible not only for emergency cover, but for transporting patients to and from hospitals and homes for the elderly. All of that has been dissipated for no justifiable and logical reason, but because of an administrative managerial change. It is incumbent upon the Government to write a very strong letter to the area health authority venting these views so that the authority can reconsider and alter its decision and restore the position that we had before the changes. If it is necessary to justify the opening of Coulby Newham on any other grounds, and if there is not the money for that, 288 the case should be argued for Coulby Newham, but not at the expense of the ambulance station at Guisborough and my constituents.

§ The Parliamentary Under-Secretary of State for Health and Social Security (Mr. Ray Whitney)
I am grateful to my hon. Friend the Member for Langbaurgh (Mr. Holt) for giving me the opportunity to pay a brief but sincere tribute to the general contribution which the ambulance service makes to the Health Service and to the population, to the skill which it demonstrates and to the response that it shows in dealing with emergencies and caring for its patients.
I know that my hon. Friend will accept that a great deal of effort goes into ensuring that services are able to respond as efficiently as they do. It is essential that local managers of the services must plan carefully the way in which the services operate to ensure that the best quality of service in provided. There is no point in having ambulance stations running a full 24-hour emergency service if there is not a demand for that level of cover in that particular area. To do so means that an ambulance may not be available in other areas where the demand is greater. I hope that my hon. Friend will accept that set of principles.
As my hon. Friend knows, the South Tees health authority is responsible for the management of the Cleveland ambulance service. As he has said, in cooperation with an independent survey conducted by the health operational research unit —HORU— which had studied emergency ambulance cover in about 20 other services in the country since 1974, the decision was taken to embark on a careful examination of the way in which emergency ambulance services were provided. Account was taken of the sort of factors to which my hon. Friend has referred, such as new roads, population changes and other developments. There was no rush to draw up proposals for future organisation of the service. A careful look was taken at the existing patterns of demand to ascertain where the relative demands of the different areas were and the times of the day when demand was greatest.
I understand that the district health authority was mindful of the fact that the Guisborough ambulance station had only a small emergency work load which, on average, amounted to less than one emergency call each night, two emergency calls each day and between one and two calls each evening. It judged that such a small work load could not justify emergency cover at that ambulance station on a full 24-hour basis, especially when other areas placed higher demands on the service. Instead, it proposed that between 8 am and 12 midnight emergency ambulance cover would be provided by outstationed ambulance crews allocated to the area.
The health authority was satisfied that under this arrangement the national standards for response time would continue to be met in Guisborough. It should be emphasised, as my hon. Friend has said, that the national standards for non-metropolitan areas such as Guisborough are lower than those for built-up areas. The health authority decided to aim for the higher metropolitan standard for Guisborough and for the entire Cleveland area. I suggest that that is a clear sign of the authority's wish to provide the best possible service to all the patients within its area.
289 But that was not the end of the story. The authority issued a full consultation document on its proposals and invited comments from a wide range of groups and individuals. We shall consider his argument about the failure to register or receive some of the comments. During the consultation period, officers of the authority attended over 30 gatherings throughout the area to explain the proposals and to answer questions. Written comments were received from a wide range of organisations, including neighbouring health authorities, community health councils, local authorities at various levels, trade unions, the staff of the ambulance service and individuals, including parliamentary colleagues.
The health authority considered carefully each and every comment received. On one particular aspect—namely, whether the proposed arrangements for emergency ambulance cover in Guisborough would result in a satisfactory level of cover—some concern was expressed. Although the health authority was satisfied that such cover would be satisfactory, it recognised the strength of feeling within the local community with regard to the proposal. My hon. Friend has reflected that concern again tonight.
The health authority decided to increase ambulance cover by providing a vehicle additional to the original proposals, between the hours of 10 pm and 6 am. That would mean that Guisborough would still have one emergency ambulance allocated to the area. The only difference is that the vehicles will not be based at the Guisborough ambulance station—this was the matter to which my hon. Friend referred—but the arrangement would enable a satisfactory level of cover for my hon. Friend's constituents.

§ Mr. Holt
Would the Minister kindly note that none of the representations that he has mentioned were in favour of the alterations.

§ Mr. Whitney
That may not be surprising in relation to proposals of this nature. Those who tended to accept them would not on the whole make representations.
The Health Service has said that the service will be closely monitored in the future. I assure my hon. Friend that there is no question of this being offered as a sop to those who question the new arrangements. It is a clear demonstration of the commitment of the health authority to ensuring that a safe and efficient service is provided. The Department is satisfied that this monitoring will be carried out properly. Certainly, if difficulties occur, which my hon. Friend fears, changes will be considered.
Clearly, what my hon. Friend has said tonight will be taken into account carefully by the health authority. I have no doubt at all that my hon. Friend will be watching the situation closely and will continue to draw any difficulties that he sees to the attention of the health authority I, too, shall follow the situation closely. I hope that this high level of cover in Guisborough will continue.
I understand the sense of loss for the vehicle, but I also understand that much work has gone into the se arrangements. The cover for my hon. Friend's constituents is at a very high level.