Ambulance Services and National Heatwave Emergency

(Urgent Question): To ask the new Secretary of State for Health and Social Care if he will make a statement on ambulance services and the declaration of a national heatwave emergency.

Our ambulance service performs heroics every single day, and I put on the record my thanks to every single one of its staff for their dedication and hard work. We have a duty to support this vital service and give it the resources it needs.

The latest figures from the NHS in England show that ambulance service response time performance has improved month on month, and that ambulance hours lost are also improving month on month. However, we fully acknowledge the rising pressures facing the service, and there are three significant factors influencing the situation. First, bed occupancy is currently around 93%, which we would normally see during winter. Secondly, there are high rates of hospital covid admissions—whether “with covid” or “because of covid”—and that puts pressure on A&Es’ ability to admit patients. Thirdly, void beds are running at roughly 1,200, partly due to a 16% increase in the length of stays. Delayed discharges are another significant influence, but they remain flat. We also have record numbers of calls to the ambulance service—100,000 more compared with May last year. There is therefore significant pressure on the system.

We also have to be mindful of the weather in the coming days. We do have a heatwave plan for England, which was published earlier this year—I am sure the hon. Gentleman has read it—and we also have the hot weather plans that NHS trusts have put in place. In addition, we are providing sector-specific guidance setting out the best way to protect people who may be at risk. We are also supporting the service more widely to make sure it has the resilience it needs. We have allocated £150 million of extra funding for the ambulance service this year, and we are boosting the workforce too. The number of national 999 call handlers had risen to nearly 2,300 at the start of June, which is a considerable increase on the previous September, and we are on track to train 3,000 paramedic graduates a year nationally every year until 2024. On top of this, we have invested £50 million in NHS 111 to help give extra capacity to the service.

Thank you, Mr Speaker, for granting this urgent question, but what a disgrace that the Secretary of State is not here. Our NHS is going through the biggest crisis in its history, every ambulance service is on the highest level of alert, patients are forced to wait hours in pain and discomfort, and he is yet to say a word about any of it. The Home Secretary was not at the Home Affairs Committee this morning, and the Health and Social Care Secretary is not here this afternoon. This is not even a Government in office, let alone in power.

One person who is still in office, however, is the Minister. Her boss resigned saying he could not put loyalty above integrity any longer. Well, the Minister obviously made a different choice. Can she say whether any further meetings of Cobra are scheduled beyond the meeting held on Monday? As we saw during the pandemic, public health emergencies require clear communication from Government. Can she tell the House what the consequences of a national heatwave emergency would be for schools, public transport services and other public services, and what guidance will be provided to the general public? What assessment has she made of the suitability of care homes to protect residents from the extreme heat, and what contingencies are in place should further measures be necessary?

Every ambulance service is now on the highest level of alert, so what is the Secretary of State doing about it? The Minister talks about targeted help for ambulance services—she is going to be hitting the phones this week; presumably the Secretary of State is too busy—but, as I think she acknowledged, this is a crisis across the health service. Last month, a crew in the west midlands waited 26 hours outside A&E because clinical staff were not available to hand over to. What are the Government doing to provide additional support to A&Es during this heatwave? These pressures are not new. Average waiting times for stroke and heart attack victims are one hour. Patients in the north-east were told to phone a friend or call a cab rather than rely on emergency services. Is it not the case that, although extreme weather is of course putting further pressure on our emergency services, it is 12 years of Conservative underfunding that has left them unable to cope?

Can I say how disappointed I am at the shadow Secretary of State’s response? If he is not happy that a female Minister with over 20 years’ experience in the NHS is able to answer a question on NHS waiting times, I find that very disappointing.

As I said in the debate a few weeks ago, I do not want to bring politics into health because I think it is too important, but if the shadow Secretary of State wants to play politics, I will give him politics. If we look at Wales, where Labour runs the NHS service, we see that the ambulance service and A&E departments are facing exactly the same pressures. Only 51% of red calls in Wales are being seen in eight minutes; the target is 65%. If he looks at the call time for strokes, he will see that only 17% of those people are being seen in time. Those numbers are falling month on month, whereas in England our responses are improving month on month. On the four-hour wait in A&E in Wales, 34.9% of people have been seen within four hours.

The hon. Gentleman shakes his head, but he stood at the Dispatch Box just now and said that Labour would do better. It is not doing better in Labour-run Wales; it actually has either similar response times or worse response times.

I have set out a plan. It is clear that the hon. Gentleman has not read the heatwave plan for England, which was published earlier this year, because he would have the answers there. We are making sure that all NHS trusts are prepared. I am happy to work with each and every Member across this House to make sure that the ambulance service, our A&Es and hospital trusts have the support that they need, but if all he wants to do is play politics, I think that is extremely sad.

Would the Minister like to put on record her thanks to all the hard-working ambulance crews of the West Midlands Ambulance Service, particularly those working throughout the county of Shropshire? Does she agree with me that this is not just about ambulances, but about local authorities—in my case, Shropshire Council and the borough of Telford and Wrekin—working alongside acute trusts such as the Shrewsbury and Telford Hospital NHS Trust? A collective effort is required, not a single effort by a single ambulance service.

I thank my right hon. Friend, who is absolutely right, because a number of factors are influencing the wait times at A&E. While delayed discharges are not increasing, there are still a significant number of them, which means that the NHS and local authorities have to be working together. That is why we have created the integrated care boards, which Opposition Members voted against, to better co-ordinate care between health and social care so that we can have better systems in place to discharge patients sooner. As I have said, we have 1,200 void beds, which is either due to infection control measures because of covid rates increasing or because patients cannot be discharged. I will be meeting every single ICB in the coming days, because as part of our winter preparation, we need to improve co-ordination in those areas.

Last October, I revealed through a parliamentary written question that every ambulance service in England was at the highest alert level. We are now nine months on, and we are in that situation again. We are facing warnings of extreme weather this weekend. The Government need to reinstate the funding for discharge packages into social care homes. We need primary care to be used to stabilise people in communities, and we must be using first responders from the fire service. Will the Minister agree to convene an urgent meeting of Cobra today to protect patients and paramedics, who are really operating at the brink?

I say to the hon. Lady that we have put additional investment this year—over £150 million of extra funding—into ambulance services to help them meet demand, because they do have significant demand. The rates we are seeing at this time of year are the sorts of rates we would normally see in winter, and we are doing exactly as we would then. We have our heatwave plan, which was published earlier this year, and we are confident that we are working with all NHS trusts, and all the ambulance trusts too, to make sure they have the support they need. Can I gently say to her that this is not just about funding? This is about bringing care together to ensure that hospital beds are freed up so that when ambulances arrive at A&E they can unload their patients. As I said to the shadow Secretary of State—I am not sure if he is going to take me up on this—I am happy to work with every single Member across this House to make sure that we support our emergency services.

I welcome the reassurance the Minister has provided regarding capacity and resilience planning over the coming weeks. A&E services at Blackpool Victoria Hospital have been under significant pressure of late, and the planned £15 million Government-funded improvements to increase capacity there frankly cannot come soon enough. Will the Minister meet me to discuss the progress of these plans to ensure that patients can see the benefits as soon as possible?

I thank my hon. Friend, who has been campaigning vigorously for better healthcare provision in his local area. I am very happy to meet him to discuss those plans, and I recognise that there is an urgency about that. I can reassure him that six areas of the country account for about a third of the handover delays, and we are specifically focusing our efforts on them. This is about relieving the pressures in the system, whether through more capacity at A&E so that patients can be seen more quickly once they arrive by ambulance, or support for the ambulance service itself. I am very happy to meet him to discuss the problems in his local area.

Despite the promises and assurances that the Minister set out in the heatwave plan and in her response, I am very disappointed that previous promises made in the House by the Minister, that she would speak with North East Ambulance Service whistleblower Paul Calvert, my constituent, have not been honoured. If Ministers will not engage with those who identify ongoing problems and learn lessons to fix our failing ambulance service, how can we expect the ambulance service to respond to an acute crisis such as the current heatwave?

The North East Ambulance Service is one of three areas of concern in terms of performance. I reassure the hon. Member that I have met the families, and offered other families a meeting, to discuss the matter. In relation to his constituent, there is a tribunal ongoing. It is difficult for me to meet him while that is ongoing. Once that is over, however, I would be happy to meet his constituent to discuss the issues that he raised as a whistleblower.

The Minister will be aware that the chances of recovery for those who suffer a stroke are greatly improved if they get specialist care within the first half hour, 45 minutes or so. So will she do everything she can to address administrative blockages and other delays, to ensure that people get the chance of life-saving treatment at the earliest possible stage?

Yes, and I thank my right hon. Friend for raising that point. Different response times are required, depending on the reason for the call. Strokes would be a C2 emergency, for which the target is 18 minutes. The latest figures we have are from May, when we were performing better than in April. The figures are not where we want them to be, but we are seeing month-on-month improvements. For C1 and C2 cases, which need urgent treatment as soon as possible, particularly for strokes, every minute counts and we want to see further improvements in those times.