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| It's happened! It's actually happened! A common sense, practical idea on ambulance services from the Welsh Government. (Pic : EMRTS Cymru) |
After a longer than usual Easter recess, the National Assembly has returned for summer term. Although the election will be on everyone's minds, it's important to remember that AMs still exist, and I'm sure many of you are as bored of the election as I am by now.
The Assembly debated the increasingly thorny issue of opencast mining today, and I'll return to that either Friday or at the weekend. For now, I'm going to focus on a debate on those rarest of rare things : a good idea from the Welsh Government.
We all know the Welsh Ambulance Service Trust (WAST) has been going through a rough patch that's lasted the best part of a decade. It's roundly criticised for lengthy response times to life-threatening (Category A) 999 calls, delays in handing over patients at hospital A&E departments and has been seriously affected by both management problems and plummeting morale; see also :
- Ambulance required for the Wales Ambulance Trust
- Why are Welsh ambulance response time so poor?
- Dear Vaughan....
Backed by around £5million in
public funds, the Welsh Government and Wales Air Ambulance have
collaborated to launch a 12 month trial of an Emergency Medical Retrieval and Transfer Service (EMRTS) - or "flying doctors"
(after the cheesy 1980s/1990s Australian medical drama) - based on a
similar service which operates in western and northern Scotland.
From its two bases in Welshpool and Swansea, it aims to bring 95% of the Welsh population to within 30 minutes of A&E care. There's a good overview here from the Assembly's Members Research Service.
Instead of transporting critically-ill patients to A&E by ambulance, it uses high-tech mobile equipment to "take A&E to the patient" (including consultant A&E doctors), allowing conditions to be stabilised at the scene and enabling patients to be transported to A&E at speeds unachievable by road.
Deputy
Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth) –
who was wearing a poppy rather early this year –
started by listing his objections to some of the amendments (clip).
He accepts some of the challenges patients face in rural and remote
parts of Wales, and the key aim of EMRTS is to provide patients with
life-threatening conditions immediate access to specialist care; it'll also provide critical care support for neo-natal (mother and
baby) teams.
EMRTS has learned the lessons from military and civilian equivalents, and the evidence suggests we can expect a 40% improvement in treatment times for trauma victims and a 30% reduction in mortality rates. The scheme has already brought highly-qualified doctors and some of the most advanced equipment of its kind to Wales, some of which has been developed via the military. EMRTS launches on 27th April, providing a "world-class transport service" and will ensure "reconfiguration plans can proceed safely".
Shadow Health Minister, Darren Millar AM (Con, Clwyd West), said the Conservatives welcomed EMRTS "from the outset" as rapid access to life-threatening emergencies can save many lives (clip). He hoped the Welsh Government would welcome moves the UK Government have made to cut VAT on fuel for air ambulances and provide funding from LIBOR fines.
He then decided to go on a bit of a rant. We shouldn't forget the "record poor ambulance performance", including the worst three months ever. In some parts of Wales there's only a 1 in 2 chance that an ambulance will turn up within the 8 minute target time. Darren said there were problems throughout unscheduled care services in Wales – like out of hour GPs and irresponsible A&E visits – and part of the problem is caused by removing services and cutting beds.
He placed the blame squarely on Labour, but also the Lib Dems and Plaid Cymru, accusing the parties of being hypocritical for campaigning to retain services yet pushing through "record-breaking budget cuts".
Plaid Cymru's health spokesperson, Elin Jones AM (Plaid, Ceredigion), decided to adopt a different tone to Darren Millar (clip), saying there was nothing to object to, and Plaid put forward amendments which would add to the service. She described EMRTS as "exciting" as it expands beyond the practice of simply transporting patients by helicopter – which is useful for rural residents and tourists alike.
The Wales Air Ambulance is one of the most popular charities in Ceredigion (for obvious reasons), and while Plaid would prefer to see the air ambulance nationalised, she accepts that charitable status and independence from the NHS does provide some advantages. Elin said Darren Millar was right to say there's a broader context of poor performance of the ambulance service generally, and the need to make continuous improvements, but EMRTS is an important addition in its own right.
William Powell AM (Lib Dem, Mid & West Wales) welcomed the principle of EMRTS, calling upon the deputy minister to keep AMs in the loop on performance (clip). He rejected the Tory amendments because the service shouldn't be written off before it starts. He said it was right to point out the poor performance of Welsh ambulance services, but the tone of Darren Millar's "schadenfreude" was harming the morale of staff.
He was also disappointed the deputy minister rejected any notion of developing a critical care centre in Powys, as the English NHS is currently planning to centralise services towards Telford from Shrewsbury – which would affect cross-border care. William ended by calling for a boost to community hospitals, reversing the "mania for urban-centric centralisation".
The Deputy Llywydd, David Melding (Con, South Wales Central), then made a welcome intervention, telling AMs it was "naïve to the point of stupidity" to believe that mentioning the UK election (AMs were making "tiresome references" all afternoon) would change people's voting behaviour. He said those doing so were "demeaning themselves".
Joyce Watson AM (Lab, Mid & West Wales) said the motion didn't go far enough (clip), as it was the "first service of its kind in Britain" (Nope! As mentioned, Scotland beat us to it.). She acknowledged that it was a huge opportunity, but also an equally-sized challenger in terms of logistics, telecommunications and collaboration. Joyce wanted assurances from the deputy minister that everything was ready to go and an update on the 27 proposed landing sites being developed around Wales. Then she completely ignored what David Melding said moments earlier and come out with a load of guff about what a Labour UK government would do to roll back privatisation in the NHS yadda, yadda, yadda....
In response, Vaughan Gething said he was "grateful" that the chamber recognised EMRTS will save lives that currently would not be saved (clip). He confirmed the Wales Air Ambulance wants to retain charity status, and that independent research and monitoring of EMRTS will take place in partnership with Swansea University.
On the critical care issues in Powys, he said the English NHS was acting without consulting Welsh patients. He also said EMRTS was ready to go live on time and would be the first national service of its kind, meeting and exceeding international trauma care standards, as well as helping to save people suffering heart attacks, strokes and severe sepsis – citing the recent heart attack suffered by a Brynamman rugby player.
The motion, which passed unanimously and included amendments from Plaid Cymru and the Lib Dems:
From its two bases in Welshpool and Swansea, it aims to bring 95% of the Welsh population to within 30 minutes of A&E care. There's a good overview here from the Assembly's Members Research Service.
Instead of transporting critically-ill patients to A&E by ambulance, it uses high-tech mobile equipment to "take A&E to the patient" (including consultant A&E doctors), allowing conditions to be stabilised at the scene and enabling patients to be transported to A&E at speeds unachievable by road.
EMRTS has learned the lessons from military and civilian equivalents, and the evidence suggests we can expect a 40% improvement in treatment times for trauma victims and a 30% reduction in mortality rates. The scheme has already brought highly-qualified doctors and some of the most advanced equipment of its kind to Wales, some of which has been developed via the military. EMRTS launches on 27th April, providing a "world-class transport service" and will ensure "reconfiguration plans can proceed safely".
Shadow Health Minister, Darren Millar AM (Con, Clwyd West), said the Conservatives welcomed EMRTS "from the outset" as rapid access to life-threatening emergencies can save many lives (clip). He hoped the Welsh Government would welcome moves the UK Government have made to cut VAT on fuel for air ambulances and provide funding from LIBOR fines.
He then decided to go on a bit of a rant. We shouldn't forget the "record poor ambulance performance", including the worst three months ever. In some parts of Wales there's only a 1 in 2 chance that an ambulance will turn up within the 8 minute target time. Darren said there were problems throughout unscheduled care services in Wales – like out of hour GPs and irresponsible A&E visits – and part of the problem is caused by removing services and cutting beds.
He placed the blame squarely on Labour, but also the Lib Dems and Plaid Cymru, accusing the parties of being hypocritical for campaigning to retain services yet pushing through "record-breaking budget cuts".
Plaid Cymru's health spokesperson, Elin Jones AM (Plaid, Ceredigion), decided to adopt a different tone to Darren Millar (clip), saying there was nothing to object to, and Plaid put forward amendments which would add to the service. She described EMRTS as "exciting" as it expands beyond the practice of simply transporting patients by helicopter – which is useful for rural residents and tourists alike.
The Wales Air Ambulance is one of the most popular charities in Ceredigion (for obvious reasons), and while Plaid would prefer to see the air ambulance nationalised, she accepts that charitable status and independence from the NHS does provide some advantages. Elin said Darren Millar was right to say there's a broader context of poor performance of the ambulance service generally, and the need to make continuous improvements, but EMRTS is an important addition in its own right.
William Powell AM (Lib Dem, Mid & West Wales) welcomed the principle of EMRTS, calling upon the deputy minister to keep AMs in the loop on performance (clip). He rejected the Tory amendments because the service shouldn't be written off before it starts. He said it was right to point out the poor performance of Welsh ambulance services, but the tone of Darren Millar's "schadenfreude" was harming the morale of staff.
He was also disappointed the deputy minister rejected any notion of developing a critical care centre in Powys, as the English NHS is currently planning to centralise services towards Telford from Shrewsbury – which would affect cross-border care. William ended by calling for a boost to community hospitals, reversing the "mania for urban-centric centralisation".
The Deputy Llywydd, David Melding (Con, South Wales Central), then made a welcome intervention, telling AMs it was "naïve to the point of stupidity" to believe that mentioning the UK election (AMs were making "tiresome references" all afternoon) would change people's voting behaviour. He said those doing so were "demeaning themselves".
Joyce Watson AM (Lab, Mid & West Wales) said the motion didn't go far enough (clip), as it was the "first service of its kind in Britain" (Nope! As mentioned, Scotland beat us to it.). She acknowledged that it was a huge opportunity, but also an equally-sized challenger in terms of logistics, telecommunications and collaboration. Joyce wanted assurances from the deputy minister that everything was ready to go and an update on the 27 proposed landing sites being developed around Wales. Then she completely ignored what David Melding said moments earlier and come out with a load of guff about what a Labour UK government would do to roll back privatisation in the NHS yadda, yadda, yadda....
In response, Vaughan Gething said he was "grateful" that the chamber recognised EMRTS will save lives that currently would not be saved (clip). He confirmed the Wales Air Ambulance wants to retain charity status, and that independent research and monitoring of EMRTS will take place in partnership with Swansea University.
On the critical care issues in Powys, he said the English NHS was acting without consulting Welsh patients. He also said EMRTS was ready to go live on time and would be the first national service of its kind, meeting and exceeding international trauma care standards, as well as helping to save people suffering heart attacks, strokes and severe sepsis – citing the recent heart attack suffered by a Brynamman rugby player.
The motion, which passed unanimously and included amendments from Plaid Cymru and the Lib Dems:
- Notes the launch of EMRTS, which will improve emergency care for rural populations.
- Regrets the failure of the ambulance service to hit its response time targets.
- Calls for the Welsh Government to introduce an intermediate care fund to keep people out of hospital A&E departments and greater investment in community hospitals.
- Welcomes UK Government moves to support air ambulances through cuts in VAT on fuel and subsidies from LIBOR fines.
EMRTS launches next Monday. It will save lives, will put Wales at the cutting edge of emergency medicine and will hopefully provide a much-needed good news story for the Wales Ambulance Service.
It's not like me to be cynical, of course, but the fine print that snuck past AMs yesterday is that this is being done, partially, to allay one of the main fears about centralisation of accident and emergency services : that it would take longer to get to hospital.
There's another catch too – the service will only operate for 12 hours a day.
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