Motion made and Question proposed, That this House do now adjourn.—[Mr. Ryder.]10.22 pm
§ Mr. Ted Garrett (Wallsend)It is somewhat regrettable that I am forced to detain the House for another half hour. I would like it to be known that this is only the second time in 23 years that I have sought an Adjournment debate. Therefore, I do not take the matter lightly when deciding upon a subject for an Adjournment debate I wish to draw the Minister's attention to the deterioration and decline in the Northumbria ambulance service. I speak with some knowledge about the ambulance service because, on 5 July 1948 when the National Health Service Act came into being, I was a founder member of the Northumberland ambulance service committee. Out of the shambles of the post-war period we were able to create an efficient organisation from scratch and that service was extended to include the Tyne and Wear metropolitan county council area. That reorganisation was carried out with the minimum of fuss.
The breakdown in that excellent organisation started when the present chief of the ambulance service decided on what was euphemistically called an efficiency campaign. That was two years ago and since then the service has virtually collapsed. It is the source of bitterness and cynicism among the electorate of the area and all quarters of the populace are fed up with the whole business.
Public concern was such that the 10 councils within the area of the administration of the ambulance service decided to fund and conduct an independent public inquiry. That was decided upon because they could not get the regional health authority or the ambulance committee to take seriously the bitter complaints that were being received not merely by Members of Parliament but by other leaders within the community. They were forced to do that.
An independent committee was set up with some excellent members. It was fortunate in having Lord Ennals as chairman, the former Secretary of State for Social Services, and its membership comprised Mr. Alan Fisher, former general secretary of the National Union of Public Employees, Mr. Malcolm Collett, principal lecturer in medical sociology at Newcastle upon Tyne university and Mr. Sidney Grahame, technical adviser and former chief ambulance officer for Gateshead and Sunderland. Those men had some knowledge of that vital sector of public service.
That independent committee took evidence from a variety of sources. It published its report in the spring of last year. I regret to say that, although the Government were informed of the report and given copies of it. no response has been received. There was very little response from the regional health authority or the ambulance committee. Indeed, the recommendations in the report, to my knowledge, have never been implemented. I believe that they have been ignored.
The service continued to decline from that time. Local Members of Parliament, doctors and the general public can all relate negative examples of their experiences of the service. My hon. Friend the Member for Houghton and Washington (Mr. Boyes) raised the matter in a debate some months ago, but nothing happened.
1193 As I have said, the recommendations of the independent inquiry were ignored. Representations by the northern group of Labour Members of Parliament to officials and representatives of the regional health authority were ignored and nothing happened. Petitions with thousands of signatures have been submitted to various sources but nothing has happened. All those matters should have been looked into, but instead we have had some weak promises from some of the officials.
I could go on for some time. I have received hundreds of complaints, as have other hon. Members representing the northern region, not merely Labour Members but members of other parties as well. I can give an example of a complaint that I received last week. A lady should have attended hospital every day for radium therapy. On one day she waited five and a half hours for the ambulance to bring her home after treatment. It is difficult to imagine her physical and mental state during that wait. The following day she waited four hours, but worse was to come. One day when she was ready to go to hospital to receive her daily treatment and after several telephone calls, she was informed at 4.30 in the afternoon that the ambulance would not be coming.
Similar cases abound in the region. The region stretches from Berwick on the border down to the boundaries of Durham and out through Northumberland and Durham to the borders of the Pennines. It is a hugh area and many people depend on the ambulance service. Many people do not have their own cars. In some cases the vehicles for the ambulance service are the sort of vehicles that convey people to hospital with the minimum of inconvenience.
The morale of the staff is at rock bottom. They are threatened if they complain. Very often they are forced to do single manning where, in their judgement, there should be double manning and often, on the two-person system, only one turns up. From what we have gathered in the press and from consultations with union people and ordinary members of the public, it seems that joint consultation by the officials and representatives of the union is a mockery.
The scale of frustration, anxiety, misery and fear that has been imposed on the people within the area of the ambulance service is a public affront to the people and requires urgent action. It is a shame that a service that was admired for its pride and efficiency has deteriorated to the extent that it has.
I urge the Minister to use the powers that he has to make a clean sweep of the people responsible for the collapse of the service. The hon. Gentleman must therefore request the resignation of the chairman of the ambulance committee and its members. He must request the resignation of the chief ambulance officer and the two people with higher responsibilities—the chairman of the regional health authority and the senior administrator. If they refuse to resign, he should use the powers available to him to seek their dismissal. I am confident that they will be replaced by people who will put human needs before bureaucratic needs. I urge the Minister once again to act decisively to end this shameful abuse of bureaucratic powers over the people of the north-east.
§ Mr. Don Dixon (Jarrow)I thank my hon. Friend the Member for Wallsend (Mr. Garrett) for introducing this 1194 important subject on the Adjournment. It is important to many of our constituents, certainly to those of my hon. Friends who are now here. My hon. Friends the Members for Newcastle upon Tyne, East (Mr. Brown) and for Houghton and Washington (Mr. Boyes) have had many letters and complaints from their constituents since the so-called reorganisation of the ambulance service. We as a northern group have met several times. We have had meetings with Professor Tomlinson, the chairman of the Northern health authority, and with Mr. Caple, the chief ambulance officer—and all to no avail.
We have had continuous complaints since the so-called reorganisation of the ambulance service. Over recent weeks, I have had three serious complaints about the service in our area. One involved one of my constituents, who had a serious chest complaint, was in hospital and was discharged. She went on a non-emergency ambulance back to her house. When she got back, she was laid on the bed and her husband was told, as she could not get her breath, to open the windows and doors. That lady died 10 minutes after she was taken out of the ambulance.
In the second case, one of my constituents, a 76-year-old man who had just had a stroke, had to go to hospital. I have the appointment card here. He was supposed to be picked up by ambulance at 11.30 am. The ambulance turned up at 9 am. It could not go back again. The man had to telephone for his daughter, and she had to take him to hospital.
These cases have happened only in recent weeks. If I were to tell of all the cases since reorganisation, I could go on all night. In the third case, the person had been in hospital, where he was seriously ill, for 13 days. His stepfather was told that he was to be discharged at 10 am the following day. The family went to the hospital; the ambulance had been ordered for 11 am. The family sat with the person in the waiting room all day. At 5 o'clock, no ambulance had arrived. The family had to ring the daughter, and get her from work and to come down in her car to take the person home. He was seriously ill when he got home, mostly as a result of having to wait for the ambulance to arrive. Two days later, that person died.
My constituents are irate about the ambulance service in our area. The so-called reorganisation is a disgrace. It is an unmitigated disaster. Talking to Mr. Cape!, the chief ambulance officer, is a waste of time. All one gets are platitudes and excuses. I have no doubt that my hon. Friends who are present could echo such complaints.
I thought that the Under-Secretary, the hon. Member for Derbyshire, South (Mrs. Currie), would reply to the debate. We know that the hon. Lady has made certain comments about health in the north. However, if we compare the hon. Lady with Mr. Caple, the hon. Lady looks like Florence Nightingale.
That is the position in the area. It is time something was done. It is time that the Minister took note of the comments raised by my hon. Friend the Member for Wallsend and had a thorough investigation to sort out those people who have disorganised the ambulance service in our area.
§ The Minister for Health (Mr. Tony Newton)I begin by responding to the last remark. I am sorry to have deprived the hon. Member for Jarrow (Mr. Dixon) of the pleasure of having my hon. Friend the Parliamentary Under-Secretary of State for Health and Social Security in his 1195 direct sights. I should explain that my hon. Friend was faced with some difficulty in being able to respond to the debate tonight and I thought that it would be appropriate if I responded.
I am happy to have the opportunity to discuss the matter with hon. Members. I appreciate the strength of feeling. Although I have not checked the statistics mentioned by the hon. Member for Wallsend (Mr. Garrett), I have no reason to doubt his word that he is an infrequent raiser of matters on the Adjournment of the House. I fully accept that that reflects the importance that he attaches to the matter. I note that the hon. Member for Houghton and Washington (Mr. Boyes) is in the Chamber and I know that he has raised this matter before on the Adjournment. I am also aware that the hon. Member for Jarrow has been concerned about this for some time. The hon. Member for Newcastle upon Tyne, East (Mr. Brown) is present and I know that he takes a considerable interest in this matter.
The difficulty that I face in answering tonight has two parts. First, a number of specific instances were raised in the past few minutes by the hon. Member for Jarrow upon which necessarily I am not able to comment off the cuff. However, I will see what further information I can gain from the authority about the particular cases raised by the hon. Member for Jarrow if they can be identified from the information he has provided on the Floor of the House or should he wish to give me further information to enable me to seek the authority's comments.
I am conscious that I must resist some part of the thrust of the comments made by the hon. Members for Wallsend and for Jarrow that the regional health authority and the ambulance service — including the chief ambulance officer—and I do not pretend to be quoting hon. Members accurately; I merely give the flavour of what they said—have persistently refused to respond to some of the points that have been made. I happen to have on file comments made by the regional ambulance officer on 23 December last year in response to a report commissioned by Prudhoe town council. I understand that the report had only been published on 8 December 1986. Frankly, by the standards of central Government, that is a fairly full and detailed response to a report published within not much more than a fortnight of the publication of the original document, and it includes detailed comments on a number of specific cases that had been raised. Whatever else has been said about the response, it constitutes a serious attempt to respond to the criticisms that had been put forward.
It would be less than fair to the authority and the chief ambulance officer on the evidence of the papers that I have concerning this matter, not to acknowledge that an attempt to respond has been made. However, I fully understand in the light of what hon. Members have said, that that response has not satisfied them or manifestly, on the basis of what they say, some of their constituents.
I cannot make immediate comment on specific cases although I will undertake to have those cases examined. It is right to record that according to the papers that I have, response has been made to particular cases and points that have been raised in reports in the past. I may refer to that point later.
The second difficulty that I face is perhaps closer to the fundamentals of the case put forward today. As has been acknowledged on both sides, this is not the first occasion on which the Northumbria ambulance service has been 1196 discussed in the House. I have looked at the report of the last debate and noted the undertaking given by the then Under-Secretary of State, my hon. Friend the Member for Oxford, West and Abingdon (Mr. Patten). He said that he did not expect standards to be reduced but rather that they would be improved, and he referred to early evidence that efficiency of response in terms of emergency ambulance services had improved rather than deteriorated. All the evidence that I have seen from the intervening period confirms that in response to emergency demands the Northumbria ambulance service has improved its record. I will give some of the statistics in a moment. Against that background, I must confess to some puzzlement about the reasons for raising the subject again today. At any rate, I start from the position that in my judgment the northern regional health authority, which is responsible for the running of the service, has sought to allay the fears expressed, has been monitoring the service provided and aims to maintain what appears to have been an improvement and to make further improvements.
I justify my comments about what appears to have happened on the basis of statistical evidence of improvement especially in the emergency service since the restructuring began. The statistics show clearly that ambulances are getting to emergency cases faster and that within six months of the closure of Prudhoe ambulance station 95 per cent. of emergency response times were within 20 minutes, compared with 73 per cent. before—an increase of more than a quarter and not far short of a third. In the period 1 October to 25 November 1986—the latest figures available to me—all emergency calls in the Prudhoe area were responded to within 14 minutes, which is better than the standard set by the Department for areas of that kind and reflects the fact that even in the usual areas the regional health authority has deliberately set standards which are more commonly expected in the metropolitan areas with their closer-knit populations and generally shorter journey times. I understand that even the people campaigning for the reopening of Prudhoe ambulance station, which is part of the background to today's debate, acknowledge that in this respect the service has improved since restructuring. They believe that there is room for further improvements, and that may well be so. I should be the last to say that I regarded any ambulance service as having achieved perfection, and hope that any authority concerned with services of this kind will seek to maintain and in every possible way to strengthen its efforts to ensure that the service is as efficient as it possibly can be.
With those figures in mind — I am not aware that anyone has seriously disputed the improvement in response times to emergencies which has taken place in the Northumbria ambulance service since restructuring—I am somewhat puzzled at the extent to which the concern persists. I do not dispute the fact that it persists—if it did not, hon. Members would not be here for this debate.
§ Mr. GarrettThe station referred to is Prudhoe, which is in the constituency of the right hon. and learned Member for Hexham (Mr. Rippon). He has complained bitterly. The fact is that there are people who have examined the statistics presented by the chief ambulance officer, people who are statisticians and who have disputed those figures from that area.
However, I would like to point out that my hon. Friend the Member for Jarrow (Mr. Dixon) and I come from 1197 heavily industrialised areas. Prudhoe is an urban/rural area where there is less congestion of the roads. In my car I have checked some of those times and again, keeping within the permitted speed limits, I have found that those figures understate the times.
§ Mr. NewtonI think that I must simply undertake to note the point that the hon. Gentleman has made, and also to apologise if I had mistaken one of the thrusts of the case that he was seeking to make. My file is stuffed with reports about the Prudhoe ambulance station. Given that it was adverted to by the hon. Member for Houghton and Washington in the previous debate as well, perhaps we over-estimated the extent to which that particular controversy was part of the concern that was to be reflected by the hon. Gentleman. But given that he has made it clear that he is anxious to steer the discussion on to more general ground and to relate it to the performance of the ambulance service throughout the area, let me make a number of points which are related to the performance and improvement in efficiency, as I would judge it, and also the quality and useage, of the Northumbria ambulance service fleet during the period in question.
On the figures available to me, it is certainly the case that the substantial manpower resources deployed in this service are now being better used than previously. When comparing the ratio of vehicle crew staff to patient movements—and I am conscious that measurements of this kind always sound bureaucratic, but we must have some kind of measure of the way in which resources are used—the restructured service, in manpower terms, has increased its productivity by 12.3 per cent. Putting those figures into somewhat more manageable terms, in 1982–83, for each ambulance man or woman employed, 1,312 patients were transported, whereas by 1985–86 that figure had risen by 162 patients to 1,474. Similarly if one looks at what one might call the usage of the fleet itself, I am advised that 32 new vehicles have been introduced, that they include 11 front-line accident and emergency ambulances and 21 patient transport sitting case vehicles. There are 73 fewer vehicles overall than before restructuring, which may sound like a downside case, but the fleet is travelling an increased mileage, and the net result is a substantial increase in the productivity of those employed in the service and a reduction in the costs that would otherwise have been incurred — which means, 1198 other things being equal, more money for the health authority to plough into direct patient services in other ways.
§ Mr. Roland Boyes (Houghton and Washington)I am grateful to the Minister and I am sorry to intervene in the debate of my hon. Friend the Member for Wallsend (Mr. Garrett), but I did tell him what I was going to raise.
The Minister will realise that a lot of things can be hidden behind statistics. In fact, my job used to be hiding things behind statistics. As my hon. Friend the Member for Jarrow (Mr. Dixon) and others have illustrated, it is the human factors that we are concerned about — the number of times, for example, that I have not had ambulance cover in my constituency, and so on. Would the Minister be prepared to meet the hon. Gentlemen who are here this evening, after he has had a reply from Mr. Caple, so that we can talk about the human aspect of it and not just its statistical aspect?
§ Mr. NewtonI will consider that. The hon. Gentleman, with whom I have crossed swords in a friendly way many times over the years, knows that my predeliction is always to agree to such a proposition. When I have seen the report from the ambulance officer, if it is the wish of the hon. Gentlemen that we should meet to talk about it further, I shall gladly see whether that can be arranged.
On his comment about seeing this in human terms, I hope that the hon. Member for Houghton and Washington will accept that that is what I want to do. Leaving aside the specific cases to which the chief ambulance officer sought to respond in his paper of 23 December 1986, which on the face of it reveals considerable inaccuracy in the accounts of the cases as put to him in the first place, the human effects of the organisation of ambulance services must in the end be judged by the speed of response to emergency cases, which is what most people regard as the first requirement of an ambulance service.
I am not in a position to engage in a complex statistical argument with the hon. Gentlemen about the basis on which the statistics have been constructed, but I have no reason to suppose that they have not been put together in good faith and on a well-established basis. They show that the response time in the Northumbria ambulance service has improved since restructuring. On that basis I cannot yield to the demands of the hon. Member for Wallsend that I should undertake the actions sought of me in his speech.
§ Question put and agreed to.
§ Adjourned accordingly at nine minutes to Eleven o'clock.