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That the draft Gambling (Geographical Distribution of Casino Premises Licences) Order 2007, which was laid before this House on 1st March, be approved.
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.
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.
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 do not believe that there can be any further debate on this matter. It is not now a matter for this Houseit 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.
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 of the residents of Ilford North.
Declares that we, the undersigned, being residents of Ilford North, deplore the consideration being given to the reduction of services at, or the closure of, King Georges hospital.
The King Georges hospital provides vital medical facilities for Redbridge residents. Any cutting of services runs the risk of putting lives at risk and leaving vast numbers of residents without local medical attention.
The Petitioners therefore request that the House of Commons takes a note of their objection to the reduction of services and the possible closure of King Georges hospital and ask the Government to act accordingly.
The Petitioners, as in duty bound, will ever pray.
To the House of Commons,
The Petition of residents of Otley and Wharfedale, the surrounding area, and others
Declares the petitioners serious concerns about the future of the Wharfedale Hospital and services at that hospital, following the sudden closure of Ward One at the Wharfedale.
The Petitioners therefore request that the House of Commons urges the Secretary of State for Health to use her powers to prevent any further cutting of services at the Wharfedale Hospital and calls upon her to provide assurances that the future of the hospital is secure.
And the Petitioners remain, etc.,
Mr. Stephen O'Brien (Eddisbury) (Con): Nestling in the hills of Cheshires 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 TLCa misnomer, as it is anything but tender loving care; it is the transforming learning communities programme of the local education authoritythe school is trying to meet the surplus places requirements of the Governments ill thought through strategy, which is putting at threat an absolutely outstanding school.
The Petition of the residents of Harthill and neighbouring villages declares that the decision of Cheshire County Council to consider the closure of Harthill School is wrong and that by doing so the Council would deprive the community of a viable and much valued and high achieving educational and community asset whilst giving rise to overcrowding in schools in surrounding areas. This is at odds with the commitments made by the Department for Education and Skills to seek to strengthen the place of schools at the heart of their communities, and the new duty placed upon local authorities to promote choice, diversity and fair access to school places and school transport as stated in the Five Year Strategy for Children and Learners.
The Petitioners therefore request that the House of Commons shall urge the Department for Education and Skills to reconsider the decision to consider the closure of Harthill School and to direct Cheshire County Council to allow it to remain open.
And the petitioners remain, etc.
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 déjÃ 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 years 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 trusts 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 years 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
against a background of weak performance in relation to response targets from all three trusts.
We are confident that, while recognising the local issues, larger trusts will deliver a better, more responsive, more efficient service, which people have a right to expect.[ Official Report, Westminster Hall, 7 February 2006; Vol. 442, c. 229-32WH.]
Unfortunately, the position has got worse since then. In my constituency at that time, about 48 per cent. of category A responsesthat is, calls dealing with life-threatening caseshit the Governments 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
Minister will be aware that I raised the matter at Prime Ministers Questions on 21 March. In response, the Prime Minister said:
In fairness to the ambulance and paramedic services in the hon. Gentlemans constituency, I think that he will find that they will tell him that they have improved considerably over the past few years. Massive investment is going into our ambulance services and paramedics, although of course we always have to improve on it.[ Official Report, 21 March 2007; Vol. 458, c. 810.]
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 Ministers 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 clearand, to be fair, I do not think that that trust is eitherabout 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 serviceswhether real or perceived by constituentshas 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.
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 timebetween 20 and 50 minutesand 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.
The expected £1.6 million saving that we
and the public were told would be re invested into front line services, has disappeared into the PCT
Fed up with driving from one end of the county to the other,
We were doing so well before the matrix came along then it all went down hill like Keanu Reeves on roller skates. Its never been any good since. Go back to the system that worked...Why do we have a two tier service? City and Town residents get a marvellous service, even the ones that like their alcohol. But live in any of the rural areas and youre forgotten and not cared about. Waiting half an hour to an hour for an Ambulance to arrive is not acceptable so why allow it?
So Sat Nav makes you drive 20 plus miles in under 8 minutes??
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
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 beforeI am due to meet some of them in my constituency next weekand 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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