One of the leading critics of private involvement in the NHS has attacked measures to replace out-of-hours GP cover in one of Scotland’s most remote communities.

Professor Allyson Pollock said residents in Kinloch Rannoch were being asked to provide the funding and volunteers to man a new service introduced after the area’s GP opted out of on-call duties.

She said NHS Tayside had privatised “core services” in using the firm First Response.

Writing in The Herald today, Professor Pollock, head of the Centre for International Public Health Policy at Edinburgh University, said untrained volunteers would take over operations previously carried out by trained medics. “There is no evidence a volunteer with five days’ training, and neither medical nor paramedic qualifications, can substitute for GP care,” she wrote.

Professor Pollock said the Tayside health board had broken promises to replace the “void” left in out-of-hours cover during two-and-a-half years of arguments with locals. This was despite other rural health boards such as Highland and Grampian managing to provide cover.

Under the NHS Tayside plans, First Response would supply a 12-person volunteer force with £15,000 set-up costs from “community and charitable donations”.

Professor Pollock added: “No citizen, let alone elderly people in their 70s and 80s, should be fighting for their legitimate rights and services.”

Providers of internet telephony must now allow emergency 999 calls over their networks or face the risk of enforcement action, regulator Ofcom has said. Caller location information must also be provided where technically feasible.

The new rule for Voice over Internet Protocol (VoIP) providers came into force on Monday. It affects businesses such as BT, Vonage and Skype that offer services that connect VoIP calls to the public telephone network.

Operators must now provide the ability to make calls to 999, the emergency number used in the UK, and 112, the number most used in other EU countries. Ofcom previously told operators to place stickers on equipment or on-screen labels indicating whether or not emergency calls were possible over a service.

The rule, known as General Condition 4 of the General Conditions of Entitlement, also provides that the network operator must provide Caller Location Information for calls to the emergency call numbers “to the extent that is technically feasible”.

Ofcom said that ‘technically feasible’ should be taken to mean that location information must be provided where the VoIP service is being used at a predominantly fixed location.

In May, a child died in Calgary, Canada after an ambulance was dispatched to the wrong address in response to an emergency call placed by his parents using a VoIP phone. The ambulance had been dispatched to an address in Ontario, 2,500 miles away.

The requirements already apply to fixed line and mobile communications providers but the VoIP industry had resisted their extension. In December last year, Voice on the Net (VON) Coalition Europe was set up as a lobby group to influence the regulation of internet telephony.

The group, which includes Google, Microsoft and Skype among its founding members, warned against the “premature application” of emergency call rules to VoIP services that are not a replacement for traditional home or business phone services”.

The VON Coalition said the move “could actually harm public safety, stifle innovations critical to people with disabilities, stall competition, and limit access to innovative and evolving communication options where there is no expectation of placing a 112 call.”

Investigations are under way to see if an ambulance breakdown was connected to a spate of recent engine fires.

A crew pulled in off the A55 at Rhuallt Hill “as a precaution” after steam was seen billowing from the engine.

A specialist team is already inspecting three other ambulance Mercedes-Benz engines after they caught fire last month.

The service bought a £16m fleet of Mercedes-Benz ambulances last year when the 160 vehicles were hailed as the “best in the UK”.

But after the unexplained fires this month the service has launched a joint investigation with Mercedes-Benz.

The first drama happened on the A55 on August 16 when a fire started in an ambulance engine during a routine transfer to Walton in Liverpool. The crew and patient had to get out.

A second fire happened in Bangor on August 18, when an engine burst into flames outside the city’s fire station where the blaze was dealt with.

A third fire happened in South Wales but no details have been released about that.

The Welsh Ambulance Service said “minor modifications” were expected to be complete by next week across its new 119-strong fleet after tests.

Firefighters attended the latest incident on Thursday but said there was no fire.

The Welsh Ambulance Services NHS Trust wants to establish if the incidents are linked.

A spokesman said the crew was returning to its base at Holywell from Ysbyty Glan Clwyd with no patients on board. He said the vehicle was taken away to one of the Trust’s garages for inspection.

A WAS spokesperson said: “We can confirm that an emergency ambulance developed a mechanical problem whilst returning back from hospital to base and the crew pulled the vehicle over as a matter of precaution.”

A North Wales Fire and Rescue spokeswoman confirmed officers attended because of fears the engine may have been alight, but said the problem appeared to be steam.

Mercedes-Benz has started an “urgent investigation” following two engine fires in north Wales and one in the south of the country.

“The ambulance service said it was working ‘very closely’ with the motor company’s UK technical team to investigate the cause of the engine problems.

“To date there has been a minor modification, tested and approved by Mercedes engineering in Germany, this is part of an ongoing process with the vehicle manufacturer,” said the spokesperson.

“Welsh Ambulance Service in partnership with Mercedes-Benz UK have worked extremely hard and quickly to carry out this modification and it is hoped the rest of the ambulance fleet will be finished in the next few days.”

Ambulances were queuing up to drop off patients at a stretched Swansea AE department.
Eight vehicles were waiting to drop off casualties at Morriston Hospital during the jam a week ago.

A health campaigner claims it meant patients were waiting for hours before they were seen.
Ambulance chiefs have confirmed that between 6.10pm and 6.33pm last Saturday eight ambulances arrived at the accident and emergency department to hand-over patients.

The situation lead to some delays, which slightly hit the time it took for ambulances to get back on the road. Sketty councillor June Stanton said she was concerned about the hold-ups, and said she feared plans to replace the Singleton unit with a GP-led service would make the situation even more “unsafe”.

Trust bosses have said the changes are needed to avoid sudden closures of the unit overnight because of doctor shortages.

Councillor Stanton said: “Eight ambulances were recently waiting outside Morriston Hospital.
“I was told by a woman that her brother-in-law was rushed in an ambulance, and he had to wait for hours in the queue of eight ambulances.

“It was because they couldn’t accommodate the patients in A&E.”

A spokeswoman for the Wales Ambulance Service confirmed the delays. She said: “We experienced peaks of high demand in Swansea.

“At one point, between 6.10pm and 6.33pm, eight ambulances arrived at Morriston A&E department to hand- over patients.

“Due to the level of demand, the service did experience some delays, which resulted in the average turnaround time for vehicles being slightly extended.

“Senior managers at both trusts are continuing to work closely together to monitor the service.”
A spokesman for Abertawe Bro Morgannwg University NHS Trust said despite the problems it only missed the Assembly’s 15-minute hand-over target on three occasions and the service had one of the best figures in Wales.

He added: “Between July 28 and August 18, for example, nearly 99 per cent of patients arriving by ambulance were transferred to our A&E in the Assembly Government’s 15-minute target.

“Of course, all A&E departments experience fluctuations in demand when we might need to prioritise patients depending on their needs, but on Monday and Tuesday we achieved 100 per cent compliance on the hand-over target.

“During a busier period on Saturday, we missed the 15-minute target on just three occasions, and just once on Sunday.”

A baby with haemophilia was not taken to a specialist centre for four hours after banging his head.

Kai Nugent fell cutting his lip and, knowing he was a haemophiliac, mum Kamila called 999.

When paramedics arrived Kamila gave them paperwork from Alder Hey Childrens’ Hospital detailing how Kai had to be taken straight there to receive specialist care.

“But they said no, it is not our policy and we are not insured, we’ll have to take him to Warrington Hospital,” said Tony, Kai’s dad.

Kai was taken to Warrington Hospital despite desperate pleas from Kamila to take him straight to Alder Hey.

“I believe the ambulance service do a very good job and they have a very difficult job to do but there is clearly a policy that caused that delay,” said Tony, a police officer from Orford Road.

“They have a duty of care to the patient not to that policy,” he said.

“For them to put the policy and the insurance of the ambulance service before the interests of a 14-month-old child is ridiculous,” said Tony, aged 47.

The family then faced a three-hour wait at Warrington Hospital while transport was arranged.

“We were seen by a doctor who had no experience in blood disorders and who was reluctant to send us to Alder Hey,” said Tony.

“He did call them and they said to get us over there straight away, but by then it was a four-hour delay from injury to treatment,” he said.

“I think they have a big problem at Warrington Hospital,” said Tony.

Tony and Kamila endured similar treatment with their elder son Kristian, now three.

When he was one-and-a-half he bit his tongue but hospital staff did not immediately run tests for haemophilia despite it running in Kamila’s family.

“They even came in and stripped him to count his bruises and then said we weren’t allowed to take him home because they thought we were beating him,” said Tony.

He and Kamila lodged a complaint with Warrington Hospital about their treatment with Kristian but say nothing has changed for Kai.

A spokesman for Warrington Hospital said there are no specialists in haemophilia there as the regional centre is at Alder Hey Hospital.

A spokesman for the North West Ambulance Service said the service is conducting an internal inquiry and it would be inappropriate to comment further.

A Southport paramedic jailed for taking nearly 2,000 indecent photos of a child faces being struck off.

Gerard Lawlor, 54, of Brandon Park Court, near Hesketh Park, was jailed for ten months after pleading guilty to making 1,920 indecent images of a child.

Lawlor took the photographs between October 15, 2004 and January 6, 2005.

A judge at Liverpool Crown Court ordered him to be put on the Sex Offenders’ Register for five years and gave him a life ban from working with children.

The Health Professions Council, set up to protect the public, suspended Lawlor from his job in April last year.

The HPC’s conduct and competence committee will now decide whether he should be struck off permanently at a hearing on Monday.

The hearing will be based on the allegation that his fitness to practise as a registered health professional is impaired because:

- On December 19 last year, he pleaded guilty to making indecent images of children.

- On January 30, he was sentenced to ten months’ imprisonment, ordered to remain on the Sex Offenders’ Register for five years and received a life ban from working with children .

The Great Western Ambulance Service is to have a new interim chief executive following the resignation of Tim Lynch, who is taking up a new executive position with the Countess of Chester Hospital NHS Foundation Trust.

Anthony Marsh, currently chief executive of West Midlands Ambulance Service NHS Trust, will take up the chief executive post on an interim basis from September 29.

He said: “I am delighted to be given this opportunity to join Great Western Ambulance Service.

“Great Western has come a long way over the last few months and I am hopeful that I can help continue that progress and ensure that patients in the three counties get an even better service.

“I am looking forward to meeting the staff and managers across the Trust and learning what more can be done to improve patient care.”

Private details of 999 calls are being overheard by the public because a new ambulance communications system is not properly in place, a paramedic has claimed.

From last week a new comms system, where information from a control centre is sent securely to ambulances and displayed on screens, has been installed by East Midlands Ambulance Service.

But because the new system is not yet functioning properly, ADVERTISEMENT some calls are being sent to paramedics’ radios which have been publicly broadcasting the place and circumstances of emergencies.

A paramedic, who asked not to be named, told the Chronicle & Echo that, in one case, details of a suspected suicide attempt were clearly heard by passengers in Greyfriars bus station, where an ambulance had been sent on an unrelated call.

He said: “There were a lot of complaints to the crew because of the grim details broadcast to all and sundry.

“That is an isolated incident but the real problem is that locations of jobs are being given out, which can tell anyone nearby a particular home is going to be empty or only lived in by a sickly, elderly person. I don’t think patients or their friends or family would be impressed with that.”

It is believed the new communication systems cost about £1,000 each and a simple earpiece attachment for the radios to keep messages confidential costs about a further £10.

A spokesman for East Midlands Ambulance Service stressed patient care is never compromised when sending messages and crew members should be following guidance on using radios.

He also criticised the anonymous paramedic for speaking to the Chron.

He said:”The majority of messages to and from our control and front-line vehicles are passed in data format.

“The guidance reminds staff of the need to use their common sense and discretion when passing information verbally, for example, by turning the volume of their radio down or by checking there is no-one within earshot when a message is conveyed.

“The great majority of our committed staff work to this straightforward rule.”

He added: “It is wrong that a member of staff claims to have a concern about confidentiality and then approaches the media with confidential information in expectation of publication.”

An MP has said she is shocked by the quality of decision-making in the region’s NHS.

The comments follow Tuesday’s decision by County Durham Primary Care Trust to support, in principle, plans for public consultation over changes to hospital services.

The County Durham and Darlington NHS Foundation Trust, which runs Darlington Memorial Hospital, Bishop Auckland General Hospital and the University Hospital of North Durham, in Durham City, has drawn up proposals to concentrate acute medical services on two of their main hospital sites.

But Bishop Auckland MP Helen Goodman expressed dismay at how the decision had been taken. She said: “I was shocked at the quality of the decision-making.

The hospital trust presented a document with no numbers and no detail.

“There was no challenge, there was no testing of the assumptions contained in the presentation.

The trust failed to ask for any of this.”

Ms Goodman, who attended the trust meeting, said she was also astonished that the North-East Ambulance Service had yet to carry out an assessment of the impact of hospital changes, which could begin as early as April next year.

“They all acknowledge that transport and access in a large county like Durham is a problem, but they presented no solution,”

she said.

As the commissioner of healthcare for 500,000 people in County Durham, the NHS trust needs to approve the proposal from the hospital trust and agree that formal consultation can go ahead.

A decision about consultation is expected to be made at a joint meeting of the two NHS trust boards on September 24.

The hospital trust argues that the only way to guarantee longterm acute medical services in the area is to concentrate activity on two main sites and turn a third, as yet unnamed site into a centre for planned surgery, outpatient appointments and, potentially, a regional centre for rehabilitation.

Ms Goodman believes the plans threaten acute medical services at Bishop Auckland hospital and will result in the closure of its accident and emergency unit.

Stephen Eames, chief executive of the hospital trust, said that “very strong” transport arrangements needed to be in place before the reorganisation took place.

He said the trust was in talks to improve bus services between the three main sites and that the trust was also looking at whether it could provide transport for certain patients.

A spokesman for the hospital trust said the ambulance service was “actively involved” in the process.

Doctors have hailed well-wishers who raised thousands of pounds to replace a rapid response car that went up in smoke.

Medics had to use their own vehicles to reach major incidents after their vehicle was destroyed in August last year.

But the volunteer doctors now have a new car to attend emergencies – thanks to donations from the public.

More than £30,000 was raised for Basics Hampshire – including £10,000 from an anonymous donor – to bring the specially-equipped car, complete with flashing lights, back on the road.

Volunteer doctor Phil Hyde, who is also a specialist registrar and training officer for Basics, said: ‘We are fantastically grateful for all of the assistance we have had from the public – without them we wouldn’t exist.’

Basics doctor Brando Tamayo was attending to a 66-year-old man in Eastern Road, Portsmouth, when the old Skoda caught fire.

The new Skoda is kitted out with a special radio linking doctors to ambulance control, a satellite navigation system, bluetooth and a hands-free set.

The hi-tech vehicle is used in partnership with ambulances and enables volunteer doctors to provide life-saving, hospital-level treatment at the scene of major incidents. But it doesn’t receive a penny from the government.

‘In Hampshire it’s a total lottery whether or not you get a Basics doctor at the scene of a major incident,’ said Dr Hyde. ‘If you are so seriously injured you need a Basics doctor it’s left to goodwill and luck.

‘Our future is not in continuing to be a charity. We want the public to demand that this service is funded by the government.

‘Other emergency services are state- provided and we are trying to cause change by continuing to provide this service and showing just how much it is needed.’