BRITISH AMBULANCE MESS

Two thirds of the ambulance trusts in England are missing targets to attend life-threatening emergencies quickly because of a shortage of funding, The Times has learnt. Millions of pounds needed to fund extra vehicles and crews are instead being withheld as local health authorities struggle to balance their books before the end of the financial year, ambulance leaders say.

The number of 999 ambulance calls has more than doubled in a decade and has risen even this year as patients have become concerned about access to out-of-hours GP services, the Ambulance Service Association (ASA) said. But despite a streamlining of the service last year designed to improve performance, the latest figures obtained by The Times reveal that 8 of the 12 mainland ambulance services are failing to achieve a 75 per cent success rate for attending serious emergency calls within eight minutes.

The current situation, using year-to-date figures, compares with the end of the previous financial year when three quarters of the 31 ambulance trusts in England were hitting the target for 75 per cent of ambulances to attend priority calls within eight minutes.

Richard Diment, chief executive of the ASA, said that the reorganisation of the service, an increase in demand and a lack of funding had all contributed to a fall in performance since July. “The number of category A calls has risen by about 10 per cent week-on-week compared with last year, and the total number of calls by 6 to 8 per cent,” he said. “The public and the Department of Health expect ambulance trusts to perform to national standards, yet PCTs are saying, ‘We know these are the targets but we just do not have the resources to help you meet them’.”

Mr Diment criticised local NHS primary care trusts (PCTs), which fund the ambulance service, for letting emergency response times slip while they struggled to balance their books and meet the 18-week maximum waiting times target for hospital referrals.

Ambulance trusts in North West, West Country, South East Coast and London are among the trusts currently missing the category A target. Some say that they hope to catch up by the end of the financial year. Other trusts have recorded huge variations in the different patches they cover, suggesting that high-performing areas could be masking low achievement elsewhere. For example, in South Western Ambulance Service, Dorset hits the target consistently , while Somerset and Cornwall have failed every month since last July.

Ken Wenman, chief executive of the South Western Ambulance Service, said: “It is historically more difficult to achieve these exacting performance targets in more rural areas. However, this has been recognised by our commissioners, and work is being undertaken to assess the financial implications of meeting them.”

Targets for the ambulance service are due to be toughened from next year, when the response time clock will start from the moment a call was made rather than when all a caller’s details had been taken. Trusts will also be expected to meet a new target to answer 95 per cent of all calls within five seconds. The total number of emergency calls rose from 5.6 million calls in 2004-05 to nearly six million last year

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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