Health and Care Bill — House of Lords, 2022-02-09
Topic: Health
Joan Walmsley (Liberal Democrats, Centre to centre-left): My Lords, I hope the Government Chief Whip will send the memo round. Last Tuesday, my noble friend Lady Barker introduced a Question for Short Debate about ambulance response times. In introducing the debate, she looked behind the distressing headlines about people with life-threatening illnesses waiting too long, sometimes fatally, for an ambulance. She outlined the underlying factors important in identifying the problems and solutions for our ambulance services The NHS has set out national targets for a seven-minute average response time for life-threatening incidents. However, the average has been rising and was over nine minutes in December 2021. Targets for less serious incidents have also been rising. This amendment would put in place just one of the potential solutions to the ambulance crisis, which my noble friends Lady Barker, Lady Brinton and Lord Scriven referred to in that debate. It would set up a system for ambulance trusts to collect data about ambulance response times by integrated care system and by postcode. They would also have to publish information about where response targets were missed. In any situation that requires corrective action, it is vital that we know where we are starting from, and transparent and detailed data collection and publication does exactly that During the debate, my noble friend Lord Scriven suggested that in order to understand why ambulance services are so hard-pressed, we need to look up the line to primary care services. He was, of course, correct: many urgent cases occur because patients have been unable to get a GP appointment, despite the fact that GPs tell us they are now carrying out more consultations than ever through triage telephone consultations The problem is caused by the shortage of GPs, particularly in some areas. We have been promised 5,000 more GPs but that has not been achieved. My noble friend also mentioned the lack of community mental health services, and in some cases the almost complete absence of child and adolescent mental health services that often lead to a mental health crisis resulting in the patient calling an ambulance Another major issue is caused by problems downstream. Paramedics have to wait outside hospitals to hand over their patients to A&E staff, meaning that they cannot go out to another case. It is incredibly frustrating and demoralising for them. Sometimes paramedics have to leave a serious case in the hands of a family member in order to go to an even more serious case elsewhere. It is well known why ambulances are piling up outside A&E: there are no free beds because the patients already inside cannot be transferred to a bed in the main hospital or discharged. The main hospital cannot discharge patients because of the lack of social care elsewhere, and so it rolls on. These delayed transfers of care are the result of serial underfunding of social care and poor workforce planning. The problems are both upstream and downstream, but we cannot solve all those with one amendment. However, I hope the Minister will accept that collecting and publishing data on a very detailed basis will at least help The detail is important. During the debate my noble friends referred to the fact that there is enormous regional variation in ambulance response times. My honourable friend Helen Morgan, MP for Shropshire North, collected a worrying set of data in her very rural area, where four ambulance hubs have recently been closed. Her constituents are rightly horrified about this. Ambulance services in Cornwall have also recently shown unacceptably long waiting times, even for category 1 cases where lives are at stake Collecting the data referred to in this amendment would certainly help to identify the specific issues in areas such as these so that action can be taken. It may be harder to serve very rural areas, but residents in those areas deserve as good a service as anyone else. Better data plus better workforce planning, which we are dealing with under another amendment, would ensure that the resources available are adequate to take account of geography and other factors. I beg to move.