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Emergency Care

It is a pleasure to respond to the debate on behalf of Her Majesty's Opposition on such an important subject, which affects all our constituents and the whole country. I pay tribute to all staff in the NHS, whether in the emergency or primary care sectors. They do a wonderful job and we should praise them at every opportunity. I also take the opportunity, following my recent visit with other parliamentarians to Afghanistan, to praise NHS staff serving in the Territorial Army, especially in the emergency centres and triage centres in places such as Camp Bastion, which could not survive without the NHS contribution to our armed services. Their work there is simply fantastic. We are in a sad predicament. At one stage, when I looked at the Government Benches, I thought I was in an Adjournment debate. Only one Labour Back Bencher made a speech on the NHS. Remember 1997 and ““24 hours to save the NHS””? Yet the Government Benches could not be filled for such an important debate. Only one Labour Back Bencher, who is desperate to save her seat, contributed. If she returns, I shall consider her speech shortly. Let me consider the Secretary of State's opening remarks. I want especially to deal with urgent care. It worried me that the right hon. Gentleman appeared to refer to another review, which may happen sometime in future, into urgent care, especially a second emergency number. In looking at my notes, it was interesting to remember that the Government promised us a framework for urgent care three years ago, in 2006. Six months later, Lord Warner promised a strategy by the end of the year. In the first half of 2007, the right hon. Member for Doncaster, Central (Ms Winterton) promised that we would have an answer about the secondary number. Again in 2007, Lord Darzi mentioned it in his reports. Now, in early 2009, the Secretary of State mentions it again. We do not need it to be mentioned; we need action. This morning, Ofcom stated in its parliamentary briefing that it would conduct an immediate review—I hope that the Secretary of State is aware of today's announcement—and that it will look into the numbers that are available as well as 999. I will deal later with some of the comments about whether we need a second number or whether everything can be done through using 999. Ofcom has specifically said that it would be inappropriate to use 888. Most people understand that, especially those who live in London. Anyone in the area covered by the 7 code who had to dial 8 could end up dialling 888 inappropriately. However, Ofcom has suggested that it would be possible to use not only the 116 116 numbers, with the permission of our European friends, but triple numbers from 102 to 119, including 117. Myriad numbers are available should the Government wish to proceed. Ofcom is on board. We have been calling for the change for two and a half years. It is imperative that the public have a simple way of accessing urgent care, not myriad different services all the way through. We have heard many contributions today, mostly from the Benches behind me, and it is important that we consider some of them. The Liberal Democrat spokesman, the hon. Member for Romsey (Sandra Gidley), talked about 116 numbers, but she was slightly confused when she said that she did not want the public to go through an operator system. That is not what is proposed. Most of the ambulance trusts operate a system similar to what is proposed already. My concern is duplication. We do not have unlimited cash in the NHS. We cannot have the public confused with different numbers; nor can we have the cost of different services by different agencies. There was also some confusion when the hon. Lady responded to the interventions that my hon. Friend the Member for West Chelmsford (Mr. Burns) made on her. The ambulance service is a complex system and we need to try to understand how it operates. I ask the hon. Lady to go to one of the ambulance trusts and to sit there while staff are doing a triage call, because it is fascinating. The minute a call comes in, staff are dispatched, based on the location of the call. They would much rather turn back an ambulance or downgrade a call than worry that they were not getting people there. There is a concern about the eight-minute call, which means that staff need to get someone there within eight minutes 75 per cent. of the time. We understand that. What cannot happen, but what is happening—this has followed the amalgamation of the ambulance trusts, although I do not think that it was intentional—is that, because the number of responses getting there in time is grouped, if an ambulance trust has an urban and a rural part, which most do, it can have an attendance rate of almost 100 per cent. in time in the urban part, but almost zero in the rural part. I am sure that that is the point that the hon. Lady was trying to make.