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20 May 2008 : Column 60WH—continued
Similarly, we are reducing funding for certain policy areas, including three areas for which other Departments will take on more responsibility: sustainable development, science and innovation, and crime and drugs. We will not withdraw from those areas. Our ambassadors will remain heavily engaged where they are of particular importance to the UK, such as in the fights against drugs in Colombia and crime in Jamaica. Our posts overseas will continue to operate as bases where all Departments can locate their own staff and resources to deliver their own priorities. Our ambassadors will continue to offer Departments advice and act locally on their behalf on all the major issues affecting the UK.
Mr. Hands: Can I take the Minister back to the budget for a moment? She lauded what she called a substantial increase in funding for the FCO; I think that she said that its budget would increase from £1.6 billion to £1.7 billion over five years. That is only a 6 per cent. increase over five years, which is way below current and projected rates of inflation. Surely that means that the Select Committee on Foreign Affairs was right to point out the real-terms budget decreases? Does she agree with the Committee? From the evidence that she has just given, she must agree that they are real-terms cuts.
Meg Munn: I said that there was an increase, and I set out the amount. The hon. Gentleman has obviously been sitting there using his calculator, or indeed mental arithmetic, to work that out. We make no apologies for becoming a more efficient and streamlined organisation. I am not sure whether we will get more information from him today about Conservative commitments to spend more money. I am not sure that his Front Bench Members would thank him for that. We are looking at how to work more effectively. I have said that we will reduce administrative posts to put more into the front line. I must correct his figures: the increase will take place over three years, not five. I assure him, as he raised so many points about the financial aspects, that I have not finished with the budget.
Our new priorities are also reflected in the work of our partner agencies. The BBC World Service will launch a new Persian television channel and extend its Arabic language TV broadcasting to 24 hours a day, seven days a week. In addition, the British Council will extend its efforts to build mutual understanding with Muslim societies—the hon. Gentleman praised that work, for which I thank him—particularly among alienated younger
populations. With the BBC World Service and the British Council, we are pursuing ambitious efficiency programmes, and I make no apology for that. We are jointly committed to delivering £144 million in efficiency savings over the next three years through a wide range of projects.
The process is carefully managed. We have defined our strategy goals and we are aligning our resources with them over time, so that the sorts of problem that the hon. Gentleman wrongly suggested would occur will not occur. The decision on the language centre predates the strategic framework. It was undertaken under the previous Foreign Secretary. Having considered it, FCO Services concluded in 2006 that its language training services cost between 15 and 40 per cent. more than those offered by comparable providers. It is important that we look at the matter sensibly and put our resources where they are needed, ensuring that we are using the money in the best way. I should have thought that the hon. Gentleman would welcome that.
On scholarships and fellowships, we have consolidated our scholarship programmes and are focusing on the Chevening and Marshall schemes, the purpose of which is to build strong relations with the international leaders of the future. Again, I make no apologies for considering carefully where we want to have the most impact and putting our resources there.
As my right hon. Friend the Foreign Secretary explained in his statement to the House:
“every organisation, including every Government Department, should regularly reassess its own aims and priorities. Successful organisations stay focused on the biggest issues on which they can make the biggest difference, and they regularly readjust that focus as circumstances and priorities change.”—[Official Report, 23 January 2008; Vol. 470, c. 54WS.]
The Foreign Office’s new strategic framework will do that. It will refocus our efforts, reprioritise our resources and refresh our strategic approach. The four new policy goals that emerged from the review present a clear and concise picture of what we are trying to achieve, and associated changes to the resourcing of our network overseas indicate how we are going to achieve it.
Although we have a new strategic focus, we are determined to preserve the strengths of the Foreign Office and its staff: world-class diplomatic skills, understanding of other countries, and a sense of public service. I assure the hon. Gentleman that the combination of those talents with a sharper set of priorities will ensure that the FCO can better serve the UK’s interests internationally.
North East Ambulance Service
1.30 pm
Dr. Ashok Kumar (Middlesbrough, South and East Cleveland) (Lab): I have been trying to secure this debate for several months, and am very happy that I have now been able to do so. I would like to put on the record my thanks to Mr. Speaker for giving me the opportunity to raise this very important issue. I am also very pleased to see the Minister in her place. It will be the first time since she was appointed as a Minister that she will have responded to one of my debates. I praise her for all the good work that she is doing in the Department of Health.
Right hon. and hon. Members representing constituencies in Tees valley, some of whom are present, support the cause that I want to articulate today. I also have the strong support of all local councils in the Tees valley area.
I wish to speak about plans by the North East Ambulance Service NHS Trust to reconfigure its ambulance control rooms. The trust covers the whole of the north-east and, in Teesside, includes the whole of the former Cleveland county area. I make no criticism of any of the hard-working staff; my concern is about management proposals to alter the control arrangements. Currently, the NEAS structure has two command and control centres: one in Newcastle, operating out of Bernicia house—the NEAS headquarters in Newcastle business park—and one in Middlesbrough serving as a satellite centre to Newcastle and covering the old Cleveland county council area.
The Middlesbrough centre, which employs 25 staff, is based at Cleveland police headquarters in Coulby Newham, in my constituency. Close links have been developed with the existing Newcastle centre, and the technology is such that the Newcastle centre can act as a back-up for the Middlesbrough centre in call handling and ambulance dispatching. In a sense, therefore, we have an arrangement that functions well, and which meets the current need. However, the demands of the ambulance service are evolving. In particular, over the past few years, there has been an increasing demand on ambulance services, partly as a result of changes to out-of-hours coverage by general practitioners.
In that context, the demands by the Department for all ambulance trusts to install new digital radio communications systems had to be considered by the NEAS, as did the need to plan for heightened civil resilience in light of continuing terrorist threats. Those demands led the NEAS to set up a review of its own control and command facilities. However, I believe that it has come to a conclusion that is potentially damaging to the service provided in Teesside. It started by considering what form of configuration is needed to meet Department of Heath challenges.
On the basis of operation effectiveness, risk and cost, it came to the following conclusions. The first was that a single centre could be operationally effective and cheaply built, but face a high risk of disruption, through a technical breakdown, natural disaster or terrorist attack. The second conclusion was that, although having three or more centres would reduce the risk in such circumstances, the configuration could be confusing in an emergency. It decided, therefore, that having two independent, but
linked centres was the option to pursue. It argued that such a configuration would be robust when dealing with risk or attack at one location. The second location could easily increase its level of service through shared software infrastructure. If built correctly, it could physically accommodate staff from the affected centre, which would, I believe, provide an effective service for the benefit of local people and for local hospitals. Looking at those options in the same manner, I would have come to the same conclusion.
That issue having been resolved, the next question was where best to locate the two centres, which is where our views diverge. The NEAS looked at possible locations across the whole region, including the current centres in Newcastle and Coulby Newham in Middlesbrough. It argues that a key factor that it had to consider was the need to conform with the requirements of the Civil Contingencies Act 2004. One requirement is that when planning for control and command resilience, split sites able to assume back-up
“should ideally not share common utility services”,
“be between 15 miles and one hour’s journey from the main, or affected, site”.
On that basis, and on the ability to redeploy staff, the NEAS decided that its preferred option for two centres would be its control room in Newcastle and a second centre, 10 miles away, at Hebburn on south Tyneside.
I do not disagree that the main Newcastle control room should be one such centre—that is operationally logical—but I question the possible location of the second centre, which, for the following reasons, should be on Teesside. First, we already have dedicated staff at Coulby Newham, and relocating to Tyneside would add up to two hours daily travelling for those living south of Coulby Newham or in areas such as Stokesley, Redcar or east Cleveland, which could reduce operational ability in facilitating staff shift handovers. Secondly, there has been an offer from Cleveland police for the centre to be operated from force premises, which would either be at the existing centre at Ladgate lane or at a newly built facility for any future move. There is little evidence, however, that that offer has been carefully considered.
Thirdly, the close proximity of the two proposed centres poses risks. Both rely on the same utilities for electricity and telephone lines. I gather that most major telephone trunk lines on Tyneside radiate out on a hub and spoke basis from central Newcastle. If a major incident were to happen in Newcastle, therefore, the outlying exchanges serving the Newburn and Hebburn areas could be cut off from each other. Likewise, although I am not certain about the pattern of high voltage distribution in Tyneside, I suspect that the same pattern might be replicated in that utility area. That would not be the case for Teesside, which is in an entirely different trunk route and telephone route, and relies on differing national grid connections.
My single biggest objection, however, is that Teesside has one special characteristic that demands an ambulance control room presence in this sub-region. Teesside is one of the global centres for chemical production with almost all the key global players having plants in the area. It deals with the processing and shipping in and out of millions of tonnes of volatile and highly flammable chemicals every year. It also has two major power
stations—one gas fired and one nuclear, the latter of which is in the constituency of the Under-Secretary for Communities and Local Government my hon. Friend the Member for Hartlepool (Mr. Wright). It is probably the one nuclear power station in the UK that lies close to a densely populated area. Teesside also has Europe’s deepest mine—the Boulby potash mine, which is in my own constituency.
We have never had a major industrial incident on Teesside, but the raw materials for such an incident are there in quantity. Together with the rest of the UK, Teesside now faces the threat of terrorism. In that context, it is inconceivable that potential terrorists would overlook industrial targets of opportunity. Indeed, at one recent trial, evidence showed references to Teesside on a possible hit list. Given that heightened threat, it is clear to me that traditional joint working of all three emergency services on Teesside needs to be maintained. That must allow for a focused and localised response to all the dangers and challenges that Teesside could face. That approach has been overlooked by the NEAS.
The Cleveland emergency planning officer, Mr. Dennis Hampson, in a report presented to an emergency planning joint committee earlier this month, said that the NEAS proposal
“has the potential to make the Cleveland area less resilient.”
He went on to say that it could cause
“a loss of local knowledge of control room staff.”
Ms Dari Taylor (Stockton, South) (Lab): On the point of local knowledge, will my hon. Friend accept that, to date, the consultation with users and staff has been abysmal, and that the consultation with the local authority scrutiny committees has been lamentable? I have asked a series of questions about the problems that we would face on Teesside should the move take place, and they have not been answered. My hon. Friend is outlining the dangers that are there and I am saying that the consultation has not been full enough or sensibly carried out. Therefore, if, at the end of this, a decision is taken to move our Teesside ambulance services to Tyneside, we will ask the national health service’s reconfiguration panel to reconsider the whole process in the belief that the decision will be changed and the ambulance service will be left on Teesside.
Dr. Kumar: I agree with every word that my hon. Friend has said. In fact, I think that she has been looking over my script because that is exactly what I was going to say. I totally agree with what she said about the consultation. Many staff have said similar things to me.
Mr. Hampson also said that there was
“a need for specialist knowledge of how ambulance accident and emergency crews should respond to chemical and nuclear incidents.”
That view has also been echoed by the local council, through the health scrutiny committees and the Cleveland joint emergency planning unit. The overview and scrutiny powers of local councils are crucial in that respect. However diligent or effective the NHS trust is, it is still an appointed trust. Local councils and local councillors are directly elected. Therefore, members serving on the health overview and scrutiny committees reflect the views of their communities. They can refer matters to the Secretary of State on the grounds that the consultation
on changes by the NHS trust is flawed or not in the best interests of the public. The Secretary of State can then refer the issue to the independent configuration panel for an overarching reassessment and, if necessary, a full review.
I understand that the NEAS board is meeting on 22 May and that its proposals remain unaltered. It is clear that if the proposal is approved by the board, the matter will be referred to the Secretary of State. I then expect the proposals to be passed as a matter of urgency to the independent configuration panel, which would take on board the views of the other emergency services on Teesside. That would allow us to build an ambulance control service that truly represents the people and the needs of Teesside.
In the 11 years that I have been a Member of Parliament, I have always supported the Government. I have never even abstained on an issue. If the Government go ahead with the proposal, there will be consequences in the future. We are rushing into a zone in which we should not be. I appeal to the Minister to consider my biggest objection to the proposal regarding Teesside and its chemical plants. In the end, the buck will stop with her or the Secretary of State. The Minister knows the area very well, and I appeal to her to take note of what I have said. She knows that I have the support of all Tees valley Members on this issue, and I hope that she will give a positive response.
1.44 pm
The Parliamentary Under-Secretary of State for Health (Ann Keen): I congratulate my hon. Friend the Member for Middlesbrough, South and East Cleveland (Dr. Kumar) on securing this debate, which he has wanted for some time. He has shown an active interest in the organisation of ambulance control rooms and other health issues in the north-east, and I commend the dedication with which he serves the needs of his constituents. The same is true of my hon. Friend the Member for Stockton, South (Ms Taylor) and the Under-Secretary of State for Communities and Local Government, my hon. Friend the Member for Hartlepool (Mr. Wright) who are present today and other hon. Members who were unable to be in the Chamber for this very important debate.
I recognise that there has been considerable public interest in the control-room organisation of the North East Ambulance Service NHS Trust. I welcome the opportunity to respond to those concerns and to try to give some reassurance. I must stress, though, that the decision on the proposals for the location of control rooms to which my hon. Friend referred has not yet been made. I understand that the trust board is due to make the decision at a meeting on 22 May, so it would be inappropriate for me to comment on the specifics of the case at this time. However, I hope that an explanation of Government policy on ambulance provision may address some of my hon. Friend’s concerns.
I want to stress that the Department of Health expects all ambulance trusts to ensure that their control rooms are fit for purpose. It is their responsibility to make sure that control rooms have the capacity, capability and resilience to deal with the needs and demands of the local area. I am referring here to the needs and demands that my hon. Friend the Member for Middlesbrough,
South and East Cleveland has raised in the debate. The changes being made in the NEAS should be considered within a much wider programme of improvements in ambulance provision.
In 2005, the Department published an ambulance review, which made a number of recommendations to transform the ambulance service. To support those improvements and following a consultation, the number of ambulance trusts was reduced to 12 broadly to reflect strategic health authority boundaries. As a result of the merger, some trusts needed to streamline and improve their operations. It is right and proper that the decisions about local services are made at a local level, but, in order to support the trusts through this process, the Department of Health commissioned a review of ambulance control rooms to provide it with an overview on a range of control-room issues.
The review concluded that the needs of the English ambulance trusts would probably be best served by adopting a small number of multiple sites—a minimum of two—with each site complying with a range of minimum standards outlined in the report. There was no single recommended operational configuration, but a series of options for trusts to consider. The review made it clear that within overall best practice, it was for the trusts to determine their own control-room organisation. Trusts considering control-room changes need to make their own decisions locally about how to meet the needs of their populations and their own operational challenges.
I have been advised by the trust that the current position for ambulance provision in the north-east is not sustainable for a number of reasons. In the north-east, NHS Direct provides back-up to the ambulance service, which is not the most appropriate solution. In addition, the control room in Middlesbrough can manage only 60 per cent. of 999 calls originating in the Tees area. The proposals that the board is deciding on aim to ensure resilience and business continuity in those areas.
Ms Dari Taylor: Does my hon. Friend accept that Cleveland police has offered greater space to the ambulance service should it require it. Frankly, I do not think that the greater space has been considered.
Ann Keen: I will go on to inform my hon. Friend of some of the progress that has been made in that area.
In identifying proposals for the north-east, the trust drew on the national control room review, but also employed a consultancy to evaluate a number of existing and potential new sites for its control centres. The consultancy provided a set of independent recommendations that were shared with all stakeholders prior to a formal consultation. Five proposals were outlined in the consultation. I understand that the NEAS preferred the option of establishing two independent contact centres. It believed that that would best achieve continuation of service and provide adequate contingency in case of emergency.
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