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Mr. Walker: The basis of Mrs. MacKenzie's case--which I probably did not put well enough--is first, that she disputes that she agreed to a full and final settlement and, secondly, that she attended emergencies, as the records at Pitlochry show. It is all very well to say that people in her job should not attend emergencies, but she did attend them and was exposed to the risks of hepatitis B. The service was not protecting her against that because she did not receive the third injection.
Lord James Douglas-Hamilton: It is standard practice in the ambulance service that, if no accident and emergency ambulance is available to respond to a 999 call, any non-emergency crew available will attend, pending the arrival of an accident and emergency unit. Training for non-emergency patient transport staff includes basic first aid and resuscitation. Such skills--whether provided by an ambulance care assistant or a member of the general public--can obviously save lives. On that basis, it would not be acceptable for the service to withhold any help that it could make available as soon as possible.
I understand that Mrs. MacKenzie was not required to perform any duties or procedures for which she was not suitably trained and equipped. I note what my hon. Friend the Member for North Tayside says about the final settlement. The information that I have received is different, but this is a legal matter and Mrs. MacKenzie is free to consult her lawyer on that point.
In concluding, I would like to take the opportunity to inform my hon. Friend the Member for North Tayside about the nature of the services provided by the Scottish Ambulance Service NHS trust. The trust provides three main services to the people of Scotland--the accident and emergency service, the non-emergency patient transport service and the patient air transport service, referred to as the air ambulance service.
The accident and emergency ambulance service is the one we see in action every day on the streets of our cities, towns and villages. This is the service which responds to 999 calls made by the public. It also responds to calls made where a doctor, dentist or midwife is already attending a patient and requests an ambulance to take them to hospital within an agreed time. These calls--
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The accident and emergency service consumes by far the largest share of the considerable resources devoted to the service. By its very nature, demand for the service is largely unpredictable and a number of strategies have been adopted to optimise the use of resources. These include sector ranging, whereby ambulances, rather than operating from fixed ambulance stations as in the past, take up position at predetermined locations.
The changing demography of our towns and cities, as well as the development of the roads, can sometimes mean that ambulance stations which were ideally situated 20 years ago are now further than desirable from the populations they serve. Sector ranging is one solution to this, while another, of course, is the construction of new ambulance stations. There is currently an on-going programme of upgrading and replacing ambulance stations in Scotland and I shall, incidentally, be travelling to Glasgow tomorrow morning to open a new station at Clydebank on the west side of the city.
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The special difficulties in urban areas also call for innovative solutions. In Glasgow, paramedics on motor cycles bring emergency help when a conventional ambulance cannot reach the patient. In other cities, paramedic response units also operate. They are designed to provide an emergency response as quickly as possible. We are determined to have the best ambulance service in the world.
Scotland has the only fully integrated air ambulance service in the United Kingdom and by far the largest, operating four fixed-wing aircraft and two helicopters in addition to the back-up provided by the Ministry of Defence and Coastguard services.
I congratulate my hon. Friend the Member for North Tayside once more on securing this debate. I hope that I have managed to address his concerns and to reassure him that these matters have been dealt with in a proper and professional manner by the Scottish Ambulance Service NHS trust.
If my hon. Friend's constituent has further evidence, it should be made available to the Health and Safety Executive, and if she has evidence of criminal activity, it should be reported to the procurator fiscal. With that, I hope that I have fully covered the subject.
Question put and agreed to.
Adjourned accordingly at Ten o'clock.
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