Previous Section Home Page

Column 140

There are many players in this casualty farce, which is fast becoming a tragedy in north Staffordshire. I see that the Minister is listening attentively, and I hope that he will reply to my arguments.

Just as my constituents and the constituents of my hon. Friends had no opportunity to voice their views to the national health service locally, so the Staffordshire ambulance trust has not been provided with an opportunity for a real hearing with real independent arbitration at the false arbitration which was organised recently. There has not even been any natural justice as far as I can see, but we are asking for it through this debate. There is no way that Staffordshire ambulance trust would have been beaten by West Midlands in a fair match. Why was there insufficient detail in the original specification drawn up by the North Staffordshire hospital trust and the district health authority, subsequently to have been taken over by the shadow combined health care trust? That is bound to lead to cuts in service and quality.

Why, when Staffordshire ambulance trust offered to provide the relevant information, was that offer rejected? As a result, the Staffordshire ambulance trust had to cost its bid on the basis of actual activity levels, whereas the competing tenderers were free to make their own assumptions about the requirements. Why did a major player in the contract--Combined Health Care--appear to play no part at all?

I have recently had a letter from the chief executive of the North Staffordshire district health authority, telling me that I can expect a reply by the end of the month, but by the end of the month it will be too late to do anything about the quality of service and the jobs that we are talking about. The result, as I understand it, is that the contract will be varied to take into account mistakes made earlier. That is of no use to the Staffordshire ambulance trust, because it has lost the contract and been kicked out of play. The result is that the hospital trust will be able to show a paper saving, a result of market testing, of about £250,000 when is comes to filling in the balance sheets on 1 April, but we say that that excludes the cost of redundancies. How can the Minister justify those redundancies? How much will the redundancies cost--about £100,000? Nor does that clean balance sheet take any account whatever of the cost of setting up a new contract, which I guess will be about £75, 000. Nor does that balance sheet take any account of the disposal of 37 good ambulances. How much will that cost? Will it cost about £500, 000? How can we throw 37 good ambulances, which have been properly maintained in north Staffordshire, on the scrap heap? What kind of a health policy is that?

All those points do not even consider the demoralisation of staff, who are required to work longer hours for less money and to take their vehicles home, as my hon. Friend the Member for Stoke-on-Trent, Central (Mr. Fisher) has already said, and to provide their own insurance cover. What kind of a contract is that?

What about women and equal opportunities? We have heard a lot from the Minister and from the Prime Minister about Opportunity 2000 and women in the national health service. Indeed, a campaign was launched by the Prime Minister himself in October 1991. He was clearly talking about football again when he said :

"The NHS goal is to realise the potential of the female workforce within the Health Service so that we might effectively meet the healthcare needs of the population".


Column 141

We have a working party in north Staffordshire, of which I am proud, which considers that undertaking to bring more women into the health service and how that can be achieved. In that Opportunity 2000 document, there is even a commitment to flexible working practice. How does the Minister square that with the women who currently work part-time for the ambulance service trust in Staffordshire? Those jobs fit in with their child care responsibilities, but they are being told that, under the new contract, there will no longer be any part- time work or further flexibility.

There is a sense of deep outrage in Staffordshire, as the quick collection of thousands of names on the petition so readily showed, and especially because our community has no means of challenging the bureaucrats who have made the decision. There does not seem to be any local accountability in the national health service any more and it is time that the Minister listened to the views and wishes of local people.

I have a feeling that, somehow, the people in the NHS think that the issue of the Staffordshire ambulance service will go away. I offer the Minister an opportunity to tell us, not necessarily in the remainder of the Adjournment debate, but through a subsequent meeting, how he can work with us, understand the sense of outrage and do something about it.

11.33 pm

The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville) : I am pleased to have the opportunity to reply to some othe points that have been made by the hon. Member for Stoke-on-Trent, North (Ms Walley). First, I shall recap on precisely what has happened. The hon. Lady is aware that there is a system in the health service of purchasers and providers under which purchasers--health authorities--have to make their own judgments of what services they can contract for the good of patients. They make judgments based on what they perceive to be the best value for patients.

For many years now, hospitals have been able to market-test services that are provided to them. They are required to market-test certain services, such as cleaning, catering and laundry, and they can, if they so wish, put out other services to tender to see whether there are providers other than their own staff, or whoever is already providing that service, who may be able to provide a better service. That has happened in the case to which the hon. Lady has referred. As the hon. Lady rightly said, North Staffordshire hospital's NHS trust and North Staffordshire Combined Healthcare saw an advantage in looking for better value and quality of service by putting the passenger transport service out to tender. As she has rightly said, they have awarded the contract to West Midlands. That is a perfectly normal procedure in the health service.

The hon. Lady may remember that Staffordshire won an ambulance contract from West Midlands and now operates the service in Wolverhampton. That is because a decision was taken that the service worked better in that way. I repeat that that is a perfectly normal procedure. Every hospital has to decide who should provide the various services for it, and it must decide on the basis of how it perceives the value of that service to patients.


Column 142

Ms Walley : Can the Minister tell us why there was no lesser quality of service in Wolverhampton but we will have a lesser quality of service in Staffordshire?

Mr. Sackville : I would certainly dispute that. I have looked into the matter. As the hon. Lady is aware, officials of the region and of my Department have looked into the question whether the contract was properly let, and have concluded that both ambulance services were bidding on the same basis and against the same specification. There is no evidence that I have found--if I had found any evidence, I should be most concerned--that there was some inequity of specification in the basis on which they were bidding.

Clearly there are points to be made about wage structure. The hon. Lady has told the House that the wages offered are a quarter less than those currently being offered. She should be aware, however, that, although the basic wage is lower, there are allowances that make up the total remuneration to a figure above what is now being paid. [Interruption.] I am assured of that, and I have no reason to think otherwise.

If the hon. Lady cares to investigate the wages under the Wolverhampton contract, she will find that that is exactly the difference between the wage structure of Staffordshire and the wage structure of the West Midlands ambulance service. The hon. Lady will also be aware that, as of now, some 49 of the Staffordshire employees have applied for jobs with West Midlands in relation to the contract.

The hon. Lady asked me certain specific questions, some of which I shall try to deal with now, and others of which I shall deal with in writing or at a subsequent meeting if she wishes. She asked whether I have visited to find out what an excellent service is being offered. The Staffordshire service is one of the very few ambulance services that I have not visited in the past 18 months. I am sure that I shall have an opportunity to do so soon. I have no reason to believe that the service was defective. I am well aware that there is an excellent accident and emergency service in Staffordshire, and I have no reason to suppose that that is undermined or threatened by the arrangements. I certainly have no evidence of that.

The hon. Lady asked me whether I could draw a line under what is capable of being put out to tender. The answer is that there is no line of which I am aware. If, in the opinion of any hospital, a service would be better provided for the benefit of patients by some other provider, the hospital has the opportunity to explore that possibility. It is also possible for emergency services to be put out to tender.

The hon. Lady may be aware that the contract for the Coventry accident and emergency service is now out to tender, and I am told that Warwickshire is bidding for it. I do not know whether it will be successful, but the local authorities have decided that they think that it may be possible for someone else to do a better job. That is the reason why they are there. The Secretary of State appoints chairmen of health authorities precisely to make such decisions. The hon. Lady asked whether I was satisfied that the contract had been properly let--whether it breached any guidelines or rules. I am assured that it does not breach EC directives. It does not breach other rules. I am told that the proposal is that it should come into force a month later,


Column 143

subject to the arbitration that took place at the region because there was a technical breach of the six-month rule in the original arrangements.

The hon. Member for Stoke-on-Trent, Central (Mr. Fisher) asked me about insurance and responsibility for vehicles. I cannot answer his question now, but shall do so in writing. Clearly, it is important that, if there are such changes, they should be separately negotiated. I am afraid that I have no knowledge of that at present. Staffordshire ambulance service provides an excellent accident and emergency service. The figures suggest that it has a high Orcon response level. I have no reason to suppose that the service is being undermined by the arrangements. Such a change obviously produces unwelcome disruption. I hope that everyone involved will


Column 144

take the trouble to ensure that as many staff as possible can be redeployed, and disruption and problems are kept to a minimum. I am afraid that, after investigation, I am unable to say that the contract is in breach of the rules.

Ms Walley : What sort of inquiry has the Minister carried out ? On what basis has he said what he has just said to the House ?

Mr. Sackville : As always in such cases, following the hon. Lady's intervention, I asked the officials in my Department to look carefully at the arbitration to find out exactly what was said and agreed, and to look into the allegations that the contract was breached. The answer that I have come up with is that it was not. Therefore, I have no reason to accede to the hon. Lady's request to intervene.

Question put and agreed to.

Adjourned accordingly at nineteen minutes to Twelve midnight.


Written Answers Section

  Home Page