Minister suggests rethink on ambulance targets
The requirement that 75% of ambulances should arrive within eight minutes of a call and 95% within 19 minutes, introduced to improve the standard of service, has become a curse for managers with both the East of England and the East Midlands Ambulance services coming in for regular criticism.
MPs across the region have plenty of examples of constituents who have had to wait much longer for an ambulance, particularly in rural areas.
The suggestion that change may be on the way came during a late-night and well-attended adjournment debate in the House of Commons.
"I take the view that targets are not particularly improving services," Health Minister Anna Soubry told MPs. "I think there is a case for re-examining targets."
The debate had been called by Derbyshire MP John Mann to complain about the East Midlands Ambulance Service. EMAS is currently consulting on a scheme, designed to improve response times, which would see it closing some of its out-of-date ambulance stations and placing paramedics in stand by locations.
Mr Mann had several criticisms but chief among them was the concern that the fear of missing targets was influencing managers when deciding where to place ambulances and perhaps even which calls to prioritise.
"By definition, high-density cities will always be prioritised over low-density rural areas," he told MPs. "The average time for an ambulance to get to a job is much shorter in the city because of the density of population. In other words, the propensity of any square kilometre to have an incident is much higher simply because of the density of population."
It is a concern shared by Daventry MP Chris Heaton-Harris.
"Ambulances are being sucked into the centre of the East Midlands and they're not serving the periphery of the region because you hit targets better if you're just collecting a drunk that's fallen over in a city centre than if you're having to drive 20 miles to pick up an old lady who's fallen over."
The minister appeared to be sympathetic. As an MP whose constituency is covered by EMAS, Anna Soubry also expressed concern about poor response times declaring that "the situation is unacceptable... something is going on that is not right.
"Many people are of the view that unfortunately it is the way that EMAS is being run that is at the heart of the problem."
But she went on to concede: "This debate is a good example of where top-down, government-led targets have blighted an ambulance service - no doubt there are many other examples in the NHS.
"That is why, when this government were elected, for many of us it was on the basis that these targets, far from freeing up services and making them better, were strangling them and making them worse.
Lying on floors
"This debate is an example of targets doing all the things they were designed not to do, constricting a service and making it worse."
And while not promising to scrap them she said it was time for a re-think.
"Let's look again at these targets in the NHS to see whether they're doing the job we want them to do because it is precisely because of these targets that elderly people in my constituency have been lying on floors for up to four hours while ambulances have to go to meet a target."
The East Midlands Ambulance Service says it accepts its service has to improve. It hopes the changes it's proposing can be implemented in the next few months.
But it also believes that if targets were lifted it would be able to provide a much better service.