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Resolved,

Mr. Swire: On a point of order, Mr. Deputy Speaker. We have just had news from the other place that the Lib Dem amendment has been voted for, so the Government do not have the confirmation that they need in both Houses. Would it be appropriate for the Secretary of State now to make an announcement about what she intends to do?

Tessa Jowell: Further to that point of order, Mr. Deputy Speaker. The order has been carried in this elected House, but we understand that it has been lost by a small majority on a fatal amendment tabled by the Opposition in the other place. Obviously Ministers will want to reflect on the outcome of that vote and to come back to this elected House in due course with proposals for taking this policy forward and ensuring that the important objectives of this legislation are delivered.

Several hon. Members rose


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Mr. Deputy Speaker: Order. We cannot have a debate on a matter that has just been debated in this House. This House has made its decision; the other place has made a decision that has nothing directly to do with us. The Secretary of State has responded to a point of order in a way that I would hope is helpful to the House.

Several hon. Members rose

Mr. Deputy Speaker: I will allow a point of order from the hon. Member for Bath (Mr. Foster) as he has some connection with this, but we will not have a general debate.

Mr. Don Foster (Bath) (LD): I am extremely grateful, Mr. Deputy Speaker. The amendment that was successful in another place was in the name of my hon. Friend Lord Clement-Jones. It required the separation of the order that was before us into two halves so that some of it could go forward—

Mr. Deputy Speaker: Order. I was trying to give the hon. Gentleman some latitude, but I am afraid that he has abused it. That is not a point of order.

Several hon. Members rose

Mr. Deputy Speaker: Order. I do not believe that there can be any further debate on this matter. It is not now a matter for this House—it is for the Government to reflect on what has happened. The House must await an announcement, which the Secretary of Secretary has undertaken to give. I believe that a line has to be drawn under the matter at this stage.

petitions

St. George’s Hospital

6.59 pm

Mr. Lee Scott (Ilford, North) (Con): I have a petition signed by 5,122 of my constituents. It is supported by the Government Member in my neighbouring constituency as well as me and the local newspaper, the Ilford Recorder.

The petition states:

To lie upon the Table.


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Wharfedale Hospital, Otley

7.1 pm

Greg Mulholland (Leeds, North-West) (LD): I wish to present a petition on behalf of 5,029 people who are concerned about the future of services at Wharfedale hospital in Otley.

The petition states:

To lie upon the Table.

Harthill School

7.2 pm

Mr. Stephen O'Brien (Eddisbury) (Con): Nestling in the hills of Cheshire’s spectacular mid-Cheshire sandstone ridge in my constituency is the vibrant community of Harthill and its surrounding villages. It has a wonderful local school. Under a programme called TLC—a misnomer, as it is anything but tender loving care; it is the transforming learning communities programme of the local education authority—the school is trying to meet the surplus places requirements of the Government’s ill thought through strategy, which is putting at threat an absolutely outstanding school.

The petition of more than 840 residents of Harthill and the neighbouring villages—almost 100 per cent. of the people eligible to sign—states:

To lie upon the Table.


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Ambulance Coverage (Forest of Dean)

Motion made, and Question proposed, That this House do now adjourn. —[Huw Irranca-Davies.]

7.4 pm

Mr. Mark Harper (Forest of Dean) (Con): The Minister of State, Department of Health, the hon. Member for Don Valley (Caroline Flint), will probably be feeling a sense of déj vu because it was almost a year ago that I called an Adjournment debate in the House on the same subject, and the hon. Lady was answering on behalf of the Government, as she will this evening. My reason for holding the debate last year was to raise local concerns about the performance of the local ambulance service, the then Gloucestershire ambulance trust, which has since merged to become part of the Great Western Ambulance Service NHS Trust.

Last year’s debate followed a specific set of local incidents that highlighted the lack of ambulance cover in the Forest of Dean, which was of great concern to my constituents. We focused in particular on the trust’s use of a matrix system to allocate resources, the result of which was to take ambulances out of the Forest of Dean and other rural parts of the county and to focus on the urban centres of Gloucester and Cheltenham.

Since then, one of my towns, Cinderford, has been given a higher priority in the matrix, which is a positive feature. Unfortunately, however, that has not improved ambulance response times in my constituency. In last year’s debate, I expressed my concern about the impact of the merger on the services that would be delivered in rural areas, and the Minister said that the merger was occurring

Most importantly, she went on to say:

Unfortunately, the position has got worse since then. In my constituency at that time, about 48 per cent. of category A responses—that is, calls dealing with life-threatening cases—hit the Government’s eight-minute target. A few months later, at the time of the merger, that figure had gone up to 53 per cent. That was still pretty appalling, but at least it was better. Since the merger, the performance has worsened, and the figure is now only 45 per cent., which is unacceptable. When we compare the performance in my constituency with that of Gloucester and Cheltenham, we find that 85 per cent. of the responses in Gloucester and 82 per cent. of those in Cheltenham are within the target eight minutes. That disparity is unacceptable. My constituents pay their taxes just as those in the urban areas of the county do, and they deserve excellent services.

The concerns that I raised last year have turned out to be closer to reality than the assurances that I received from the Minister. My reason for raising the issue again, a year later, is to keep up the pressure on the Government and on the new ambulance trust to provide better services for my constituents. The
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Minister will be aware that I raised the matter at Prime Minister’s Questions on 21 March. In response, the Prime Minister said:

Unfortunately, performance is not improving, and I have written to the Prime Minister to point out that fact. I suggested that he might like to use the opportunity presented by this debate to set the parliamentary record straight, and the Minister now has the opportunity to do that. The Prime Minister’s answer did not accurately characterise the situation. I am sure that that was inadvertent and due to the briefing that he had received, but it clearly did not accord with what the ambulance trust has said.

To be fair, the ambulance trust is grappling with one of the issues that the Minister and I discussed in our debate last year, namely, the growth in the emergency call volume, which is rising by about 10 per cent. a year, and in the Great Western Ambulance Service NHS Trust by about 13 per cent. I am not clear—and, to be fair, I do not think that that trust is either—about exactly what is driving those increases. It cannot be the case that we are suddenly experiencing many more emergencies. Indeed, I have received anecdotal reports from the paramedics that my constituents in the Forest of Dean are quite reluctant to call 999. On the whole, when they do so they have a serious problem. They do not tend to call an ambulance at the drop of a hat or in inappropriate circumstances. The evidence that I have seen suggests that that happens less in my constituency than in the urban areas. I would like the Minister to tell the House why the Government think that the call volume is rising. If it carries on rising at 10 per cent. a year without any increase in resources, it will be difficult for the ambulance service to cope.

Anecdotally, paramedics have suggested to me that the change in out-of-hours services—whether real or perceived by constituents—has led to an increase, particularly at night, in parents with sick children and people looking after elderly relatives in distress calling an ambulance because of the lack of a speedy alternative response. I would be interested to know whether the Government think that that analysis is accurate, and what they propose to do nationally to address the growing call volume.

Because of the difficult geography of Gloucestershire, with the River Severn running through the middle of it, the interaction between the Great Western Ambulance Service NHS Trust and those operating in Wales is also an issue. In my constituency, Sedbury, which is the other side of the River Wye from Chepstow, is quite a long way from where the ambulances are based, and also has a significant number of emergency call targets missed. The area is difficult to cover from the rest of Gloucestershire, and I would be interested to know the extent to which liaison between the Welsh Ambulance Services NHS Trust and the Great Western Ambulance Service NHS Trust is possible and can be increased.


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To inform myself better, I spent a 12-hour shift with a paramedic crew last year. Watching their performance on the front line, I was impressed by the skill with which they handled calls, and by the effort that they put into responding quickly and safely to them. They are put into a difficult position when, through no fault of their own, they turn up after a significant period of time—between 20 and 50 minutes—and have to bear the brunt of the dissatisfaction of understandably distressed relatives or patients who expected the call to be answered more quickly.

Another issue raised last year was the extent to which savings would result from a merger of the three ambulance trusts, and whether that money would be available to invest in front-line services. The Minister will be aware that deficits in the NHS were a significant issue last year. My understanding is that some of the savings from management reductions, rather than being invested in the front line, have effectively been used to plug deficits. Will the Minister comment on that?

The change undergone by the ambulance service has also had an impact on the feelings of ambulance staff, particularly in Gloucestershire. The evidence of meetings and letters, and of a blog that they have set up, suggests to me that a number of them are unhappy and disillusioned with the way in which the system is being managed. Let me share with the Minister one or two quotations from the staff blog, which, if she is interested, can be found at greatwesternambulance.blog.co.uk.

One contributor to the blog recognises that

the paramedics”—

deficit.

Another contributor refers to being

rushing from job to job. A particularly interesting quote relates to the matrix system of allocating resources. Its contributor says:

Finally, a contributor to a discussion about improving ambulance response times by implementing a satellite navigation system, asks:

There is a certain amount of disappointment among the staff, and that is very worrying. In an organisation undergoing significant change, where staff deliver front-line care, it is very important for management to take people with them as they introduce that change. Otherwise, the organisation will not be successful.

My constituency is a rural part of the county. My constituents pay as much in tax as people in cities and towns but get a significantly inferior service. However, they are reasonable people: they know that it is difficult
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to deliver certain public services in rural areas, and they understand the challenges involved. Even so, the general view is that the disparity between the provision in Gloucester and Cheltenham and the provision in my constituency is unacceptable.

On a positive note, over the first few months of this year the ambulance trust has introduced emergency care practitioners. I have talked about them before—I am due to meet some of them in my constituency next week—and it will be interesting to see whether they can help turn things around. They should enable faster response times by being based more locally in the forest.

Last week, an interesting article entitled “On the Road with New Wave Medics” appeared in my local newspaper The Forester. The reporter, Jenni Silver, found that emergency care practitioners could speed up response times, and she wrote that the presence of a practitioner


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