Sir George praised the work of doctors and nurses in Hampshire who volunteer to work in their spare time to save lives at accidents.
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Sir George Young (North-West Hampshire) (Con): I just want to add a footnote to the excellent speech made by the hon. Member for Winchester (Mr. Oaten)—my parliamentary neighbour. As you may have seen, Dr. McCrea, a high percentage of Hampshire MPs are present.
I pay tribute to the work of Dr. Phil Hyde and the team in Hampshire for raising the profile of this issue as well as providing the help that the hon. Gentleman described. Like him, I was not aware of the service until my constituent, Dr. Louisa Chan, who lives in Whitchurch, wrote to me. She is one of 19 volunteer doctors and one consultant nurse in the county who act as volunteers working for BASICS—in her case, after doing 56 hours of full-time work for the NHS. She uses her own car with a blue light in responding to call-outs. As the hon. Gentleman said, at the moment, the team can respond to about half the number of call-outs. Of course, they are not called out every time that an ambulance is summoned; they are called out only to the more serious emergencies where their skills could make the difference between life and death. I pay tribute to those volunteers. They were very active following the train crash at Ufton Nervet a few years ago; they were on the scene very quickly.
I want to put this issue in a slightly broader context. The hon. Gentleman touched on the fact that one could argue that this is not the only service that ought to be mainstream NHS but is slightly at arm’s length from it. I suppose that the best example is the hospice movement, which one could argue ought to be mainstream NHS. It started off in this country totally independent, run by voluntary organisations, but it is now moving more towards the mainstream NHS; the hospice movement is receiving more support. In Hampshire, we have fantastic hospices: Naomi House, in the hon. Gentleman’s constituency, and the Countess of Brecknock hospice and St. Michael’s hospice in my own. That is an example of a service that started outside the NHS but is gradually being absorbed into the bloodstream, if I can put it in that way.
The other example, which the hon. Gentleman touched on, is the air ambulance, and it is quite a good parallel with the BASICS service. Until last year, the only local air ambulance service was the one in Thames valley, which I do not think has ever received a penny of public money. We now have our own one in Hampshire—the Hampshire and Isle of Wight air ambulance—which, again, I think receives no public money at all. One could say that that is slightly odd. The police have helicopters. No one has ever argued that the police should have a whip-round for police helicopters. They are an integral part of the police service, but specialist trauma response is another emergency service and, for some reason, its helicopters have to be funded in a totally different way. It is not immediately clear why that should be so.
Then we have BASICS, the service to which the hon. Gentleman referred. One could argue that the case for absorption of that service is stronger. With hospices and helicopters, there is something visible for which people can raise money, but for this service, there is nothing visible at all. It is an unseen part of the service. Therefore, one could argue that the case for total absorption and integration is stronger. It is very difficult to say that it is an acceptable risk for patients to rely on off-duty volunteers, possibly to save their lives.
Mr. Oaten: I am sorry to intervene so soon. I am grateful to the right hon. Gentleman for his speech on this issue. He reminds me about the ridiculous situation in which some consultants are on duty, operating and working in the accident and emergency department, waiting for emergencies to come in, and their pager goes off, asking them suddenly to switch to become a volunteer and go out. They cannot do so, because they are working in the hospital, and they have to wait for the patient to come in, knowing that if they had been able to go out as a volunteer, they perhaps could have helped to save a life. What better example is there of the fact that the service should be integrated?
Sir George Young: There probably is no better example, and the hon. Gentleman makes the point very well.
Last year, the Hampshire service received the Queen’s award for voluntary service. I commend it for that. The hon. Gentleman referred to the National Confidential Enquiry into Patient Outcome and Death, which highlighted the inadequacy of out-of-hospital care. It said:
“The current structure of pre-hospital management is insufficient to meet the needs of the severely injured patient.”
I agree. It seems to me that the objective should be to integrate the service that the hon. Gentleman has described into a properly funded pre-hospital service, with doctors and paramedics working together as a team.
The debate calls for a ministerial response, and I am delighted to see the Minister in his place. He can say one of a number of things. First, he could say, “These are wonderful people. I applaud what they do, and I would like to provide this life-saving service as part of the mainstream NHS, but the resources are not there, so we will carry on as we are.” Or he could say, “The case has been made. We recognise that, in most other countries, this service is an integral part of a national health service. We accept the case. We will make this a priority, and either move ahead with earmarked additional resources or ask people to do it within existing budgets.” Or I suppose that he could say that he wants to reach the same destination by another route; he wants progressively to upskill the paramedics, reduce the call-out times, put better equipment in ambulances and implement similar solutions. I am not sure whether that would achieve the same objective. The paramedics are fine. For the average call-out, they have the necessary skills, but as the hon. Gentleman said, they simply are not trained to the level of doctors.
The Minister might like to respond to this point. The new GP contract contains a provision for a national enhanced service for immediate care, but as I understand it, almost no primary care trusts have commissioned one, so there is a provision, but it is not being activated. This is what we need to know from the Minister. What is the philosophy? What is the policy? Should the service be a mainstream part of the NHS? If so, how will we get there, and as the hon. Gentleman said, who will pay for it?
I have a final point about the landing site in our area. The paradox at the moment is that, when someone called out under BASICS gets to the scene, there is almost always an ambulance there as well. If an air ambulance is summoned and takes the patient to Southampton, they then have to go by ambulance to the hospital, as the hon. Gentleman explained. The same ambulance that attended the initial incident then goes to the helipad, so there is no gain in time at all from using the helicopter. Given that paradoxical situation, there is an urgent need to make some progress with a more accessible helipad for patients who are taken to Southampton hospital. I am sure that the Minister will respond as sympathetically as he can, and I commend the hon. Member for Winchester again for raising the profile of this important but neglected subject.