AMBULANCE RESPONSE TIMES
It is reported today that, last week, you took a decision that could have far-reaching implications for ambulance and A&E services this winter.
A leaked document obtained by the Mail on Sunday suggests that, on Monday 15 December, you approved a proposal to relax the Red 2 response time from 8 to 11 minutes for some calls and to 19 minute minutes for others.
I gather that you wanted the change to have immediate effect but that it has been delayed until the first week of January.
If this is correct, it represents a major change of policy for the ambulance service and a departure from long-established working practices. While there may well be a case for making such a change, it could reasonably have been expected to be subject to careful consultation and Parliamentary scrutiny. Instead, it appears to have been rushed through, without due process, in response to the deteriorating situation in the NHS.
The leaked document makes specific reference to the unusual nature of this decision in terms of both timescale and process:
· it notes the proposals have not had the "full breadth of exposure normally expected";
· it makes clear that the discussion about the changes was limited to a narrow group of people and that the ambulance service as a whole was not consulted but instead presented with a fait accompli;
· and it records the firm view of NHS England that any such changes should not be implemented until the next Parliament.
I believe these revelations raise major questions over: (a) the safety and continuity of services this winter; and (b) your own conduct and judgement.
You will recall that I wrote to you on Friday 12 December asking you to make a statement to Parliament before the break setting out your plans to deal with winter pressures. You failed to reply and so, on Thursday, you were required to come to the Commons to answer my Urgent Question. I remind you that it specifically asked you to outline to Parliament your plans for ambulance services this winter.
Given that this was three days after you had made your decision, I find it highly unsatisfactory that you made no mention of it in response to my question or to those of other MPs. This is all the more extraordinary when we discover from the document that ambulances services were given a deadline of noon on the same day to sign a letter to NHS England supporting the change. You have treated Parliament with contempt.
This decision has implications for the NHS in all parts of England. Members of Parliament should have been informed about it and given the opportunity to challenge it, particularly given the unusual nature of the way it has been made. Instead, you appear to have deliberately kept Parliament in the dark and given an incomplete answer to my question.
Given the seriousness of the situation now facing the NHS, and the need for people to have confidence in your public statements, it is imperative that you now correct this error of judgement and provide answers to these 10 questions:
1. Is it correct that you approved this change on Monday 15th December?
2. If it is, why did you make no mention of it when you answered my Urgent Question on Thursday 18th December and what justification do you have for withholding such important information from Parliament?
3. Is NHS England in support of making this change now or does it still consider that a longer timetable is needed?
4. What categories of patients will now be expected to wait longer for an ambulance as a result of this change and what evidence do you have that these longer waiting times are safe?
5. Will you publish all evidence and advice, both clinical and operational, which you considered as part of your decision-making process?
6. How many people were involved in the discussion of these changes, who were they and for how long was this matter under consideration?
7. Did you receive any warnings on the risks of making these changes at short notice in the middle of a difficult winter and were any of the people you consulted opposed to your plans?
8. Why were the 10 ambulance trust Chief Executives not fully consulted?
9. What plans do you have to communicate these changes to the public and the rest of the NHS?
10. Are you confident that it is a safe and sensible course of action to continue to implement these changes in the first week of 2015 given that the vast majority of people working in the NHS have only found out about them today?
I expect nothing less than a full response today to each of these questions. If you do not have an acceptable reason for withholding information about your decision from Parliament, I suggest you should prepare to make a full apology to the House at the first opportunity after it returns from recess.
Rt Hon Andy Burnham MP