Select Committee on Defence Minutes of Evidence

Examination of Witnesses (Questions 940 - 959)



Syd Rapson

  940. Can I say, first of all, I represent Portsmouth, as Mike does, and certainly I am very proud of the Hampshire Ambulance Service, no less than Essex and London. They have met all their targets against these plans in the budget and the morale of staff and in the South East where house prices are phenomenal, how they get fire, ambulance and policeman to work, I do not know. The Ambulance Service is certainly excellent. I want to go into the co-ordination of the Ambulance Service as one of the blue light services. Certainly you have to have robust arrangements to work with the police and fire service and under the Ambulance Service Association memorandum it describes the Ambulance Service supporting the Government proposals to encourage all three blue light services to develop more common approaches, joint training and operational procedures. Are you satisfied that co-ordination and co-operation arrangements between the three of you are adequate at all levels?
  (Mr Roberts) No, it would be very complacent of us if we were to claim that, I think. This Association and the two professional police and fire ones were party to a three presidents report which actually looked at what services could do better together. That report is currently with ministers. Ministers have asked us to bring them some more concrete examples, the radio system is one of them. We do work fairly closely together on a day to day basis now anyway and that is why I think the issue of representation is so important. If we really are partners then partnership does not have to be equal but there has to be some equality in it. What we were finding was that police and fire were very, very well represented, they were both in the Home Office, although fire is now DTLR, and we tended to be the poor relations coming along at the back. I think professionally, as three heads of professional services, my colleagues in police and fire and I are working very closely together but we need the national doctrine, the national agreements and we need to push them down. At the end of the day it comes down to individual people, avoiding turf wars down in Hampshire or anywhere else, and generally I think we are working quite well. There are some raw sensitivities, I think it would be daft to say there were not.

  941. The Ambulance Service itself has expressed its full commitment to working better with the other services? You have done that, there is no doubt about it.
  (Mr Roberts) Yes.

  942. The memorandum again goes on about representation. It states in particular "In return . . . for this commitment . . . the Ambulance Service would expect . . . " and this is what you are asking for—give me, give me—" . . . equal representation on all relevant committees and national working groups so that our views can be directly considered in the same way as our partners". What in particular is it that is worrying about representation where you are not adequately represented or you feel you are taking a lesser share in the decision making? Can you put your finger on it? Am I being a bit too fussy?
  (Mr Roberts) I suspect there are two dimensions. Outside health the Cabinet Office started to get very proactive in terms of cross Government issues. If you look at the Cabinet Office, they have got police secondment, they have got fire secondment, they have got nobody from the Ambulance Service. Therefore, either we tend to go by default or people guess for us and I think then we end up doing damage limitation jobs or running to catch up, quite frankly, if we have got a partnership that is not acceptable to the service. Within the health service I think there is an issue about ambulance and health, it is a bit like saying "Well, the fire service is a part of local government". People say because they have consulted health that embraces ambulance. We are an integral part of the NHS, we do not want to be anything else, but we are a different part in many ways from the hospital end and from the public health end. Therefore, trying to get somebody who can represent all three sometimes means one of us falls off the end and usually it is the Ambulance Service. We are quite keen internally, within the Department of Health, to make sure that we are there when the decisions are made and a cross Government that our voice is there when decisions are made.

  943. You talk about the NHS for yourself and local government for the fire service and the police have got their own police bodies. Are they in any way a hindrance to your co-ordination of the services: the bureaucratic monsters out there that we talk about sometimes without a knowledge? Is that a hindrance to you, is that holding you back? Can you arrange the co-ordination and the procedures between you and overcome their reluctance to merge as much as you are doing?
  (Mr Roberts) Locally I think we do not have a problem, it is about individual chief officers and the general relationship at operational level is fine. I think it is at the policy making more strategic level.

  944. That is Government level you are talking about?
  (Mr Roberts) Yes, generally.

  945. County or regional level you would work it out yourselves.
  (Mr Roberts) Yes.


  946. In any local exercises are you fully integrated in the process of emergency planning at town level or city level or county level?
  (Mr Roberts) Yes.

  947. You have no anxiety?
  (Mr Roberts) No. Funding is the anxiety.

  948. Of course.
  (Mr Roberts) And the value you get from these exercises sometimes versus the cost. If you look at ambulance services, everybody now wants exercises and one ambulance service probably covers a fair number of local authorities, there will be an airport or two, there will be British Rail, Railtrack, they all want exercises and nobody wants to pay.

Mr Cran

  949. Gentlemen, would it be correct if the Committee started from the proposition that the Ambulance Service really has a considerable knowledge of dealing with terrorist incidents or would it be more correct to say that some of the ambulance services in the country have that expertise?
  (Mr Roberts) The latter. Some ambulance services have significant experience in dealing with incidents, not the type of terrorism that maybe is chemical and biological but certainly they have a lot of experience in dealing with the other types. London in particular probably has more experience than anybody in the world in dealing with major incidents of various kinds.

  950. I ask the question from the standpoint that, as I have said on a number of occasions in this hearing, I am no terrorist but if I wish to have an incident in the United Kingdom, I am not sure I would wish to choose London simply for the very reasons you two have given, I would wish to choose another of the major cities. Now in answer to a question from Mr Hancock you touched on London but what about the other major cities: Leeds, Manchester, Edinburgh, Glasgow and so on? In other words, just whilst you are thinking, if there was a major incident such as 11 September in one of these cities, could the Ambulance Service deal with it?
  (Mr Roberts) If there was an incident like 11 September in any city in the UK we would struggle to deal with it. In some ways from a health point of view if you get a large number of people dead then it is still a major incident but the problems it presents to us are very different from, let us say, the sarin attack in 1996 in Tokyo where you have got lots of live casualties, they have all got respiratory distress, they are panicking, all our plans are premised on the fact that we can corral people in a way, we can hold them there and deal with it at the scene. If it is going to take us 40 minutes to get there, they are not going to be there by the time we get there, not if they have got any common sense. I think 11 September changed our thinking fundamentally about the risk side. In terms of day to day major incidents, most ambulance services have got significant experience. In terms of terrorism, London, Manchester, and a few other cities have had some kind of incident, usually with warning, usually with time to prepare and places have been evacuated, and again that would have been very different from 11 September. Almost every ambulance service will have been responding on a fairly regular basis over the past 20 years to suspected parcels, this, that and the other but none of us is up to speed or resourced to deal with things like 11 September.

  951. It really is a very serious statement that you have made, highly critical of all the structures around you that provide the resources so you do your job properly. I get the impression as I go through this inquiry that in the good, old British way there is a great deal of calm, commonsense being spoken but underneath all of that I am not sure I see a great deal of really meaningful action. Therefore what I want to hear from the two of you, and I am in no way critical of you, of course, is that very, very, very stern representations are being made to those who provide the resources to solve the problem. You have already said, if there were a major attack in, let's say, Glasgow of the type in New York, you would struggle badly. What other representations have there been and who is saying no?
  (Mr Roberts) I would like to make it very clear that if I am sounding critical of the infrastructure, I do not mean to be. At the end of the day, what happened on 11 September is that it changed all our planning assumptions. Our planning assumptions up to then were about major incidents. We do not deal with natural disasters in this country which cause thousands of casualties and go on for weeks, we generally tend to have short, sharp, major incidents, a couple of hundred casualties dealt with in four hours. So I do not think I imply any criticism that we were not better prepared. Certainly I think for chemical incidents we ought to have been better prepared and we are now. So those are the things which are positively happening. What we need is time. We cannot get our preparations up to speed for 11 September-type incidents, even if we had all the money in the world, in the short term. There has been no civil defence in this country since the 1960's, so there are logistical issues about where we get the staff from and so on. We are making strong representations, but I am not sure that 11 September is a particularly good example, from where I sit anyway, of the type of incident we would be planning for. It is the probability and the risk I think that is an issue.

  952. Are you one of those, and is the Ambulance Service as an institution one of those, who says, "11 September was a very exceptional event, it is probably not likely to happen again and therefore what we are going to do is plan on the basis of opportunity cost, what is the likelihood that the same thing will recur", which really does mean, does it not, you discount an awful lot of the possible threats which might come along? Is that the approach of the Ambulance Service?
  (Mr Roberts) I would not go quite that far. The reality is we spend the money rather than make it. I think someone has to take decisions about how far you go in terms of those national risk assessments.

  953. Are those around you who provide the resources putting that pressure on you to say, "Hey, of course to meet every eventuality we could come up with a figure, but because that might not be affordable or whatever we have to go for something less and therefore scale down all the possible threats"? Are those the pressures on you?
  (Mr Roberts) No, I have not been aware of any pressures as such. I am not sure where that debate would take place. This is about a national risk assessment and a consequence of that risk assessment would be the funding issue. As far as I understand it, every spending department has been asked to ensure preparedness is built in, and it is a question really for ministers as to how much they want to spend on that.

  954. And you are putting maximum pressure on?
  (Mr Roberts) We are certainly saying—

  955. And you have costed it?
  (Mr Roberts) No, we have not. We have not costed anything except the chemical protection equipment and decontamination equipment. There is a piece of work which needs to be done to say, "What would a good response to a 11 September incident look like?" The lessons from New York are not even here yet, and with all their resources—and I was over there when the World Trade Centre was blown up the first time—how well did they really cope with it? How could we have done it differently? There has to be some scenario where you say, "There are planning limits", because if you go into these incidents which are so broad, they just become so difficult, people give up and say, "We cannot do anything about it anyway." I think it is about striking a balance personally.

  956. The Committee would be interested in knowing how the operational procedures for dealing with the victims of a terrorist attack differ from those of a major incident or a natural disaster? Are they the same or different?
  (Mr Roberts) Broadly the same. We start from an all-risks, all-hazards approach to emergency planning and consequence management whatever the cause. However, there would be some differences. If there are security differences, if there are chemicals or biological agents involved then you have added complications, but the basic tasks, which are about rescue, about assessment and then definitive treatments, are broadly the same.

  957. So there is an easy transfer of expertise and knowledge?
  (Mr Roberts) Yes, I think so.

  958. The Committee would be interested in knowing whether the armed services have a capability that you could and do draw upon. We take the view that the Army Medical Services probably are not much help to you, but are other elements of the armed services? Would they be of use in these sort of incidents?
  (Mr Roberts) Our planning assumption, what we have been told, is that we should not assume the Army can lend us any support. They may well be fully engaged in dealing with their own problems. There are arrangements in place for Military Aid to Civil Authorities but our planning assumptions are that anything we get from the military would be a bonus. Clearly in detection, which is one of the big issues, what are we dealing with, the experience and expertise of the military is going to be very important.


  959. It depends how long they take to get to you. Your guys and girls would reach an incident fairly quickly and, without the training, could blunder into a crisis not knowing it was something they had never personally experienced, or even read or been instructed about. With the best will in the world, it could take hours before the small number of units which are capable are driven to you—hopefully not up the M6 at 5 o'clock on a Friday afternoon but helicoptered—so what happens in the meantime? That is a grave worry. Then you find what you are dealing with is a chemical or biological attack. You would obviously spot a nuclear attack but not necessarily a chemical or biological one, or some appallingly communicable disease.
  (Mr Roberts) I agree, Chairman. We rely on other people to do the detection. We do not have any detection equipment, the police and fire might have some. We would be very reliant on their advice in terms of whether we go in or not. The protection of our initially-attending crews is a critical issue for us because we envisage—although the national doctrine might come out different—trained teams for chemical and biological attacks rather than trying to train everybody, because that would be very difficult to do.

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