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Bob Spink (Castle Point) (Con): While the hon. Gentleman is talking about massive changes due to reform, is he aware that Essex strategic health authority is trying to remove the excellent cancer centre from Southend hospital? Does he agree that there can be too much change to, and meddling with, NHS structures without any clear purpose or evidence that it will improve service levels and outcomes, which should be our aim?
Mr. Martlew: The hon. Gentleman wanted to get that in. I have got to know him well over the years and suggest that one reason why he lost his seat at one election was the way in which the Conservatives ran the NHS.
Let me come back to the serious problems caused by reorganisation in Cumbria. In 2002, I wrote a letter to the chief executive of the North Cumbria health authority, who has now retired. I said that the proposals being put forward for my area—the hon. Member for Falmouth and Camborne (Julia Goldsworthy) used this term—were a "dog's dinner".
Keith Vaz (Leicester, East) (Lab): The hon. Lady said, "Dog's breakfast."
Mr. Martlew: My hon. Friend is right.
I said at the time that it was nonsense to create three PCTs in the area of north Cumbria, which used to be Cumberland, for its population of 350,000, but that was what happened. One of the PCTs covered fewer than 70,000 people. All the other north Cumbria Members disagreed with me, as did all the district councils and the county council, but in 18 months, instead of having three management teams, it was decided that there would be one management team and three trusts. We thus have the nonsense at the moment of having three chairs of trusts—one for west Cumbria, one for Carlisle and one for Eden—and those trusts' non-executive members, but one management team. It cost millions of pounds to make the change, but it caused tremendous confusion about which PCT was responsible for which service because, for example, Carlisle and District PCT could end up being responsible for services in west Cumbria. That is why I support the reorganisation.
Cumbria and Lancashire strategic health authority has come up with a solution, but unfortunately it is not the easy one, which would be to keep Morecambe Bay PCT, which is working well and covers the south of the county and part of Lancashire, and create one PCT for north Cumbria. Instead, it has decided to use the county boundaries and go for a county-wide PCT. I accept from Conservative Members that that is basically what the Government want, rather than a reasonable rationale.
Anyone who knows Cumbria will realise that it is vast. Its two centres of population are my constituency of Carlisle and Barrow-in-Furness. Those places are 90 miles apart and have little to do with each other, yet it is suggested that we create one PCT for the area. However, everyone knows that two-tier local government is to be reformed, so we could end up in three years—this is a 50:50 bet—having created a PCT for Cumbria that is not conterminous with the new local government boundaries, which would not make any sense.
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The Home Secretary announced yesterday that Cumbria is not really that important because its police service will be in with that of Lancashire—I do not have major worries about that. The ambulance service will be merged, too. I have been to see the chair of my local ambulance trust and the chair of the control. They are not concerned because they believe that being part of a big consortium will create greater buying power, so the service will be able to get the equipment that it has been lacking under the present scheme and thus be brought up to the standard that exists in the rest of the north-west. I do not buy the idea that there is an issue about mergers. If it was left to some hon. Members, we would still have the old county borough of Carlisle ambulance station. We have to think about saving money.
We need a PCT in the north of Cumbria and the one at Morecambe bay. We also need—this was mentioned by my hon. Friend the Member for North Swindon (Mr. Wills), who is no longer in his place—to take that process further. The acute trust should manage the community services and, eventually, the social services. We should have a care trust in the north of the county. That works well, as a pilot scheme in Northumberland has shown.
We will end up with another unsatisfactory situation, and we will reorganise again. We do not want any more reorganisation. It is not necessary; it costs money and on many an occasion it has cost us talented people.
The right hon. Member for Suffolk, Coastal mentioned the problem of rural areas. In north Cumbria, the population determines that we have one district general hospital, but because of the geography, that population is split between Carlisle and the west coast, so we need two. We find it very difficult to manage with the moneys that are available. Governments of both parties have ignored that. There used to be a thing called the RAWP, or resource allocation working party, formula—only two people understood it, and one of them was mad—and that never gave us adequate money. We welcome the extra resources from the Government, but I feel, and I may be alone among north Cumbria's MPs, that they have got it wrong. I felt that last time, and I was right then.
8.30 pm
Michael Fabricant (Lichfield) (Con): The hon. Member for Tamworth (Mr. Jenkins) said that he has no objection to his PCTs merging, as long as it provides a better service, but he is concerned about the criteria for such mergers. I agree with him.
I am not here tonight to talk about the South Staffordshire PCT; I am here to talk about the merger of the Staffordshire ambulance service. A few months ago, a friend of mine, a youngish guy, went jogging round Whittington, a village in my constituency. He felt sick. He did not know what was wrong with him. He went home, took a shower and started feeling worse. He went downstairs and suddenly thought, "There's something seriously wrong." He dialled 999 and then collapsed.
All Staffordshire ambulance service staff are paramedics; in fact, the service was the first in the United Kingdom to employ paramedics. The ambulances are strategically placed, controlled by global positioning system satellites, which Staffordshire was also the first to introduce. So the ambulance arrived within five
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minutes, and the paramedics defibrillated my friend. They gave him an injection of decoagulants and he was taken to Burton hospital; he survived. If that had happened in the west midlands, he would undoubtedly have died. The simple fact is that the response times in the west midlands are far worse than those in Staffordshire. In fact, Staffordshire enjoys the fastest response times not just in the United Kingdom but in the whole European Union.
Mr. Robert Flello (Stoke-on-Trent, South) (Lab): Will the hon. Gentleman give way?
Michael Fabricant: I will give way to a fellow Staffordshire Member of Parliament.
Mr. Flello: Will the hon. Gentleman mention also that, of all the ambulance services, Staffordshire probably uses the most anticoagulant drugs to good effect?
Michael Fabricant: The hon. Gentleman is absolutely right. In fact, the service's use of those drugs is beyond the normal clinical protocols for the national ambulance services. Staffordshire ambulance service can also provide angioplasty, and through cardiac enzyme testing, which is generally not available elsewhere, it can manage patients with chest pain who are not transported to hospital. There is even a cooling protocol for those with post-cardiac arrest, to stop brain damage and other tissue damage. That is unique, yet the Government, either wittingly or unwittingly, are to destroy it.
The response to life-threatening emergencies within eight minutes in Staffordshire is a staggering 88 per cent. The NHS average is only 75 per cent. In the east midlands, where there has been a merged ambulance service, it is only 75 per cent. These are Department of Health figures. For category B, which are serious emergency call-outs, in Staffordshire the response is within eight minutes 85 per cent. of the time. In the west midlands it is only 46 per cent. of the time, and in the east midlands, the model for a regional system of ambulance services, it is only 27 per cent. of the time. Any doctor will tell you that time is life. There is a golden period in which, perhaps, someone can be rescued from death. The Staffordshire ambulance service succeeds in that while other ambulance services fail.
I suspect that the Minister will say that, if Staffordshire ambulance service is merged with the west midlands, standards throughout will be raised. I do not think so, and nor does the board of the Staffordshire ambulance service. Members of the board say:
"Our concerns are that there is little, if anything, in the documents to explain how high performance will be protected.
Staffordshire consistently responds quicker, saves more lives from cardiac arrest and heart attacks and operates a cheaper response to emergency patients.
Discussions within the West Midlands region lead us to feel more, not less, alarmed at the prospects of standards falling, and of lives being lost which otherwise would have been saved."
All of us as Members of Parliament have a duty of care to our constituents. What can be more important than standing up in this House and trying to do something to stop the unnecessary loss of our constituents' lives?
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Amazingly, it is estimated that, if other ambulance services adopted the practice of the Staffordshire ambulance service, some 3,000 extra lives a year in the United Kingdom could be saved.
Yet, are the Government saying, "Yes, we will preserve the Staffordshire ambulance service and we will use its protocols across other services"? No, they are not. The Minister gave it away in her introductory speech. She said that the object of the exercise is to provide a regional-based system—but why? If it were a regional-based system that could improve response times, that would be fine by me. I would not care if a regional system were best. If it were larger than a region, that would be fine. I am interested in only one thing, and that is a better service for my constituents. What is clear from looking at the east midlands model and from listening to the professionals in Staffordshire and, indeed, in Birmingham and the west midlands as a whole, is that the fine, high standards maintained in Staffordshire would be lost, and that that would result in lives being lost in Staffordshire and elsewhere.
The irony is that the Government may be concerned solely with saving money, but Staffordshire ambulance service is the most cost-effective service in the country. It says:
"To our knowledge, there are no services of the proposed size anywhere in the world that achieve high performance"
as the Staffordshire ambulance service does. We should be rejoicing in this Chamber; the Minister should be saying, "We are proud as a Government that we have achieved that in Staffordshire, and we want to repeat it elsewhere." The Staffordshire ambulance service goes on to say:
"We would argue that the creation of eleven regional services is not only a step too far, too soon, but a barrier to high performance."
The figures are clear; the lives saved are indisputable. If the Staffordshire ambulance service is merged with the west midlands, lives will be lost. They will be unnecessarily lost and this Government will be to blame.
8.38 pm
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