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As the Minister said, the impetus for fire service reform came from the Bain review, but it focused on the need for more fire prevention, rather than just firefighting, and that can be achieved only by a community-based force. Bain specifically advised against regional reorganisation and instead proposed regional co-operation. He suggested that co-operation could achieve all the benefits without major organisational structure change. However, the Government's response ignored Bain's advice and set out to establish regional fire authorities as part of regional assemblies. Once the wheels came off the plan for elected regional assemblies, the Government ploughed ahead regardless. Had fire services been accountable to elected regional assemblies, that would have dealt with the democratic deficit created by an unelected tax-levying body, but without the democratisation of regional government the major structural reorganisation has little genuine benefit for local people.
Mrs. Spelman: I commiserate with the hon. Lady on her present ill health. I have listened carefully to her argument about the breakdown in the logic behind reorganisation. Did she say that her party is consulting on whether it should still be committed to elected regional assemblies, or is it still committed to them? I would be grateful for clarification.
Sarah Teather: We are consulting on what we should do following the north-east referendum. We accept that the proposals on offer were rejected, but many other options are possible. Some form of regional government is necessary to democratise the present systems. That could be achieved in many different ways and I do not wish to prejudge our review by discussing it in detail now. I would be happy to discus the issue in detail with the hon. Lady at some other point.
The Minister mentioned national resilience, but serious emergencies require serious contingency planning that would, by its very nature, require co-operation between services. Where would the process stop? Does the Minister suggest that it would be worth consolidating all functions into one giant structure, just in case it needs to be run from Downing street? That cannot be the way forward, although I recognise the Government's tendency towards it. Is it necessarily any more resilient to have nine large control centres instead of 46 smaller ones? The impact of taking one centre off-line would be huge.
There is no perfect solution, but compulsory regional fire control rules out the possibility of co-operation between emergency services. The hon. Members for Forest of Dean (Mr. Harper) and for Stroud (Mr. Drew) have spoken already about the successful tri-service control centre in Gloucestershire. Would that have to be broken up under the current proposals? It looks as though it would.
The regionalisation of fire services would break the links with local communities, and the same would be true of policing. We need a fire service that is much more integrated in communities, especially if we want it to deal more with prevention. What about the Divali prevention of fire campaigns that are almost certainly going on up and down the country at present? Should
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the one in Bradford be run by a city somewhere on the other side of the country? I do not think so. That is not the way to deal with local considerations.
Mr. Andrew Turner (Isle of Wight) (Con): Does the hon. Lady agree that the Minister's example of the way in which regional planning works was drawn from London? London is one place, unlike the south-east, as the Department of Health recognises. The Department has offered the Isle of Wight the opportunity to continue to have its own ambulance service, because it realises that the south-east is not simply one place.
Sarah Teather: The hon. Gentleman makes a fair point. There is a tendency to view structures that work in one area as easily transplantable elsewhere. We see that with many of the Government's ideas about city regions in the north. Their ideas might work perfectly well in some areas of the north of England, but they will not transfer well to the south-east or east of the country where the relationship between cities and rural areas is not the same. We have to accept that the one-size-fits-all approach will not deliver the improvements in service delivery that we want. It will certainly not improve democratic accountability.
There seems to be no obvious logic to the structural reorganisation proposed for ambulance services. The Government seem to have picked a random size for new ambulance trusts that ties in with none of the other tiers of administration in the national health service. Instead of reforming ambulance services into arbitrarily sized organisations, the Government should consider integrating services with hospitals and emergency care. How will it be possible to do anything sensible if trusts are not coterminous with anything already in the system? A modern ambulance service is not just about driving injured people to hospital; it is staffed by highly trained paramedics who increasingly treat casualties at the scene.
The proposed move will tear a hole in any attempt to connect the ambulance service to the rest of the NHS. Why move to larger authorities? There is no evidence to suggest that it would be more efficient or would save more lives. We have already heard quotes from the chief executive of the Staffordshire ambulance trust, who is extremely concerned. We should listen carefully to people on the ground with experience of running such services who say that a move to larger structures will not help to improve the service to patients.
Mr. Kevan Jones (North Durham) (Lab): I can give the hon. Lady an excellent example from the north-east, where the North East ambulance service has been in existence for nearly 10 years. It cuts across two strategic health authorities and numerous trusts. In the summer, I had the honour of spending a night shift with the paramedics, who found none of the problems that the hon. Lady is outlining. Furthermore, more money was coming in for new technology, which helped them to do their job.
I am sure that the North East ambulance service does an extremely good job, but I return to my earlier point: the fact that something works well in the north-east does not mean that the same structure will work well if it is applied somewhere else.
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The Government are reorganising all our public services, but that makes a mockery of the claim that the new terms of reference for Sir Michael Lyons will deal with all the possible things that might come under local government. By the time he gets around to considering them, there will not be much left for local government to do.
We are holding the wrong debate; we are talking about structures when we should be talking about accountability. The debate should be about how we can fit structures into our elected organisations and then put them under the control of elected representatives. Our party is conducting a major review of how local services should be delivered and by whom, but at the heart of our thinking will be the principle of accountability. We have learned that when 77.9 per cent. of people vote against something that we want to do, we do not plough ahead and do it regardless. Taking note of those views is accountability. That is what we should do when we are elected and it is something that the Government need to learn.
Mr. Raynsford: I have accepted and the position has been approved by the advisory committee on appointments for former Ministers, with the caveat that I should not indulge in the lobbying of Ministers for a year from the time that I ceased to be one. I hope that nothing I say now will be seen as lobbying Ministers.
I am astonished that the Opposition should table a motion about the emergency services with no reference, let alone a tribute, to the performance of our emergency services who responded so magnificently to the problems that occurred on 7 and 21 July[Interruption.] I make that comment only about the motion on the Order Paper. I was about to offer an apology to the hon. Member for Meriden (Mrs. Spelman) because I was unable to be in the Chamber for the first few minutes of her speech as I was at another meeting. She may have corrected that[Interruption.] I was making the point that the motion setting out the Opposition position made no reference whatever to the performance of the emergency services, and I stand by that.
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