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The Minister of State, Department of Health (Ms Rosie Winterton): Naturally, I do not agree with the motion, but I am pleased that the debate has given us the opportunity to pay tribute once again to the work of our emergency services, whose dedication and commitment are second to none. As my hon. Friend the Under-Secretary said—his words were echoed by my right hon. Friend the Member for Greenwich and Woolwich (Mr. Raynsford) and by several Opposition Members—the events of 7 July gave us a tragic reminder of the invaluable work performed by the people who staff our emergency services. I am sure that the whole House wants to pay tribute to them.

This debate has also allowed us to discuss how to shape our emergency services for the 21st century, and for all the new demands and challenges that we face. It is true that our police, fire and ambulance services are all undergoing change. That is not only because we want high-quality local services, but because we need to have emergency services that can deal with major incidents, whether terrorist attacks, chemical incidents, major transport accidents or natural disasters such as the floods that we have seen all too often in recent years. All the evidence and lessons learned over the past few years point to the fact that major incidents require a co-ordinated response across local boundaries. Specialist equipment is often required and personnel from a wider geographical area may need to be called upon. It has to be possible to mobilise at short notice resources from outside the immediate area. Disasters do not respect local authority boundaries and we have to have emergency services that respond to that fact.

As my hon. Friend the Under-Secretary said about the fire service, we need to upgrade our communication and control centres so that they can deal as effectively as possible with major incidents. He also said that, in July, the London fire brigade showed the importance of being able to respond at a regional level. It is generally accepted that a similar strategic approach is necessary throughout the country.

Richard Younger-Ross: The new control centres rely on phone location identification for landlines and
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mobile lines. I understand that the software for landlines is not yet in place and that it is certainly not in place for mobile telephones. Will the Minister give an assurance that no regional control room will open until that software is in place and that all phones can be identified on the computer?

Ms Winterton: I understand that, in a number of areas, the software is already in place and it goes without saying that that will all be taken into account in opening regional centres.

I felt that the debate was slightly like a branch meeting of the Fire Brigades Union, not only because of my hon. Friend the Under-Secretary's background but because of the contribution of the hon. Member for Hemel Hempstead (Mike Penning), who started well but deteriorated when he criticised some of those working in the service. In terms of the local changes to the fire service, my hon. Friend has heard the comments made by my hon. Friend the Member for Blyth Valley (Mr. Campbell). I understand that the Under-Secretary wrote back to my hon. Friend two days ago and he will respond, as he said he would, to my hon. Friend the Member for Hayes and Harlington (John McDonnell) to his points about finance. We will look into the points about the contract made by the hon. Member for North Wiltshire (Mr. Gray). I hope that my hon. Friend also reassured the hon. Member for Forest of Dean (Mr. Harper) on the new technology.

With regard to the police, my hon. Friend said that the independent inspectorate was clear that a move to larger strategic forces across England and Wales would provide the best business solution to ensure that every force had sufficient capability and capacity to provide the full range of protective services, including preparedness for response to large-scale incidents, alongside effective neighbourhood policing.

The hon. Member for Brent, East (Sarah Teather) spoke about further consultation and the police themselves have made proposals, but we will pass on her point and that of the hon. Member for Daventry (Mr. Boswell) about future consultation to follow on from the proposals, which are to received at the end of December. As the hon. Member for South Cambridgeshire (Mr. Lansley) pointed out, the ambulance services review was carried out by the chief executive of the London ambulance service. The review concluded that we need fewer and bigger ambulance trusts if they are to be able to respond to major incidents, as well as to invest in the people and resources needed to increase the range of services that they provide for patients and the public. Our proposals will ensure that resources are targeted at where they are needed most and that they improve patient care and support front-line services.

We propose that there should be 11 trusts that will align with the Government Offices for the Regions, the fire service control rooms and the proposed strategic health authorities and be set up within boundaries that enable closer co-operation with police forces. For the
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first time, ambulance trusts will be aligned both with services that respond to major emergencies and services that provide day-to-day health care.

Mr. Lansley rose—

Ms Winterton: If I may anticipate the hon. Gentleman's point, a particular example of a gain from our proposals is the training of emergency care practitioners. If that is done on a more strategic level, the training will be improved and skills and potential enhanced.

Mr. Lansley: One of the best ambulance trusts in the country—its standards are reflected in its star ratings—is the Staffordshire ambulance trust. We have heard from hon. Members across Staffordshire that the trust delivers an effective service and that it is innovative and at the leading edge of ambulance trust delivery. Why does the Minister think that regionalisation would improve that trust? The implication of what she has just said is regional control centres for ambulance services, but the Government have not said that they propose such centres.

Ms Winterton: No, that is not the case. We will consult on the proposals for 11 trusts, but we have also made it clear that decisions about control rooms will be taken at local level. There are some very good ambulance trusts and the idea is not that their standards should be brought down by merging. The idea is that they will help to improve other ambulance trusts—an idea that has worked time and again in the NHS. We will have services that can respond properly and strategically at regional level and also reflect needs at local level.

Paul Farrelly (Newcastle-under-Lyme) (Lab): The effectiveness of the Staffordshire ambulance trust has already been pointed out and my hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins) raised it with the Prime Minister. Will my hon. Friend the Minister give an assurance that, after the consultation, we will not have a one-size-fits-all solution imposed and that, if local arrangements are shown to work, the Government will not try to fix them?

Ms Winterton: If my hon. Friend had been in his place earlier, he would know that my hon. Friend the Under-Secretary made it clear that the proposals were all about being responsive at local level, as well as good strategic co-ordination. They are not about changes to front-line ambulance service provision. Local innovations and successes would be not only preserved, but shared to benefit all. This is an opportunity to lift the quality of the lowest and set a high benchmark.

The hon. Member for Meriden asked why we have proposed the changes. The answer is simple: we want better, faster services that are more responsive to major incidents. It is extraordinary that the Opposition choose to denigrate the fact that we are ensuring that our emergency services can respond as effectively as possible at regional and neighbourhood level.

What did the Conservative party offer the emergency services and the public when it was in power? Crime doubled, the NHS was run into the ground and the fire
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services, as my right hon. Friend the Member for Greenwich and Woolwich so eloquently put it, were left to stagnate with no attempt to modernise or invest in them to make them fit for the 21st century. The Conservatives learned no lessons at the last general election, because the patient's passport would have taken £1.2 billion out of the NHS—almost exactly the cost of the ambulance service in England.

The debate has once again underlined the fact that it is the Government who are in tune with what the public want—policies that the public endorsed at the general election—which is modern, up-to-date emergency services that are properly equipped, with proper training, and properly co-ordinated to save lives and protect the public.

Once again the Opposition are swimming against the tide of public opinion and fighting the battles of the past. I urge my hon. Friends to vote against the motion and for the Government.

Question put, That the original words stand part of the Question:—

The House divided: Ayes 241, Noes 298.

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