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The NHS is spending £400,000 a day on private ambulances and taxis to plug gaps in emergency care.

The biggest industrial action in health service history begins on Monday with paramedics, nurses and midwives all walking out in a dispute over salaries and patient safety. And a Mail investigation lays bare the dire state of the ambulance service with call-outs on the rise and staff quitting in droves.

Desperate bosses are increasingly turning to the commercial sector and the outlay on private ambulances and taxis has jumped 62 per cent in just three years. The bill soared to £145million in 2022 – almost £400,000 a day.

Private companies are called in on a contracted or ad hoc basis to cover the demand the NHS cannot meet, for everything from non-urgent transport for a check-up to a 999 call to a life or death situation. And with thousands of ambulance staff walking out this week, the bill will only rise.

Nurses hold their first ever 48-hour strike tomorrow and Tuesday, hitting half of trusts in England and Northern Ireland. They will be joined by 11,500 ambulance workers tomorrow and another 15,000 on Friday.

The first ever 48-hour strike action for nurses will take place tomorrow and Tuesday

The first ever 48-hour strike action for nurses will take place tomorrow and Tuesday

Data from England’s ten ambulance trusts obtained by the Mail under freedom of information laws showed that:

  • Seven spent more than £10million on private ambulances or taxis last year;
  • At half the trusts their spending on private ambulances or transfers has more than doubled in three years;
  • South Central Ambulance Trust spent the most – £30million last year at an average cost of £438 a trip;
  • The £145million outlay could pay the salaries of 3,100 extra ambulance staff.

Tory grandee Sir John Redwood said: ‘Managers in the NHS command enormous budgets and it is most important that they are better spent with a remorseless focus on better patient service.

‘It is worrying that despite all the management of the ambulance service, in desperation the NHS has to turn to the private sector to do the job in many cases. Is this the best use of resources?’

Paul Bristow, a Tory member of the Commons health committee, said: ‘This year’s budget for the NHS was £180.2billion, and next year some say it will amount to 44 per cent of day-to-day public or departmental spending. So the idea that the NHS is starved of money is simply not true. The key is to spend that money wisely, through increased productivity, innovation and better use of resources.

Data from England's ten ambulance trusts obtained by the Mail under freedom of information laws showed that seven spent more than £10million on private ambulances or taxis last year

Data from England’s ten ambulance trusts obtained by the Mail under freedom of information laws showed that seven spent more than £10million on private ambulances or taxis last year 

‘This is an example of how that is not happening. At a time when many NHS workers are striking due to a lack of pay, we must ensure that every penny is spent wisely and evidently this is currently not the case.’

The NHS is battling huge staffing problems – with shortfalls of 12,000 hospital doctors and more than 50,000 nurses and midwives – and cannot meet the increased demand for care driven by the pandemic.

Private 999 workers ‘did not notice’ cardiac arrest 

Peggy Coperman was transferred from Somerset to Norfolk in a private ambulance

Peggy Coperman was transferred from Somerset to Norfolk in a private ambulance

Peggy Copeman died on the hard shoulder of the M11 after private ambulance staff sitting next to her did not notice that she was in cardiac arrest.

After developing an infection, the 81-year-old was being transferred from Somerset to Norfolk in a Ford Transit van run as a private ambulance by Premier Rescue Ambulance Service (PRAS) in December 2019.

Her son-in-law Nick Fulcher told the Daily Mail: ‘They carried Peggy in by her legs and arms, and strapped her in with her head down and all she could do was moan.’ During the drive, Mrs Copeman’s condition worsened and she went into cardiac arrest.

The coroner said the private ambulance staff failed to provide ‘prompt medical attention’, which contributed to Mrs Copeman’s death.

Mr Fulcher said: ‘She was sat between them and they did not know that she was dying.’ When they finally realised what had happened, he said that they called the hospital before attempting to give her CPR – and when they did, they left her sitting up.

Mr Fulcher added: ‘These people didn’t even have basic life-saving skills, they didn’t have a defibrulator at all, the food in their van was mouldy and the water was out of date.’

He and his wife, Mrs Copeman’s daughter Maxine, believe that if Mrs Copeman had been treated by NHS ambulance staff, she would have survived.

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Mr Fulcher said: ‘The ambulance guys would have gotten her in the right position, but she wasn’t when the other two were trying to do CPR while she was sitting up.’ PRAS is no longer operating and its licence was suspended by the CQC in September 2021.

 

The number of ambulance staff fell by 13 per cent from 22,924 in March 2019 to 19,326 in March 2022, according to NHS workforce data. Staff are leaving for higher salaries in the private sector and better working conditions.

Paramedics can earn between £22 and £35 an hour working for private companies, significantly more than they can expect in the health service, where pay bands sit between £13.84 and £20.76.

Striking ambulance workers are demanding a pay rise but have not set a figure. They say a financial incentive is necessary to stop staff leaving and draw in recruits.

Tomorrow’s strikes were called off in Wales after NHS staff received an improved pay offer of around 7.5 per cent – but no such offer has been tabled in England.

Midwives and nurses are also set to walk out over more pay disputes tomorrow along with physios who are also striking on Thursday.

Private ambulances or ordinary taxi companies have been drafted in by all ten ambulance trusts in England to plug the gaps left by plummeting staff levels and increased demand. They responded to 20 per cent more calls last year than in 2019/20 – a total of 237,200 – with every trip typically costing the NHS hundreds of pounds.

The companies cover care from non-urgent patient transport to check-ups and appointments to emergency calls. In some areas, private companies are increasingly covering even the most serious ‘category one’ calls – seen as life or death scenarios.

Steve Brine, the Tory chairman of the health committee, said: ‘The public are still experiencing care free at the point of need but it sounds like a costly way to deliver that care. Either way, ministers need to get the promised 800 new ambulances, as outlined in the new urgent and emergency care plan, on the road in short order.’

Labour health spokesman Wes Streeting slammed the ballooning spending and said: ‘Under the Conservatives, the NHS is forced to chuck ever greater sums of money at taxi firms and private ambulances, because ambulance services simply cannot cope.

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‘Thirteen years of Conservative mismanagement of the NHS has left patients waiting longer and taxpayers paying more. We’re paying more but getting less. Labour will launch the biggest expansion of NHS staff in history, paid for by abolishing non-dom tax status.

‘We will reform the NHS to make it fit for the future, delivering better care for patients and better value for taxpayers’ money.’

At least 15 private companies raked in millions of taxpayer pounds each last year by offering private ambulance or taxi services.

One of them was paid more than £11million. North East Ambulance Trust paid £4.3million to Ambulnz Community Partners Ltd for emergency services. South Central Ambulance Trust paid out more than £7million to Polaris Medical Services. South Central said spending on private transport made up 10 per cent of its total operating outlay last year – £589,000 of which went to a single taxi company.

A spokesman said the trust faced challenges in recruiting paramedics due to a national shortage and utilising private providers allowed them to ‘offset vacancies’.

Outlay on private ambulances and taxis has jumped 62 per cent in three years

Outlay on private ambulances and taxis has jumped 62 per cent in three years

Figures from England's ten ambulance trusts obtained by the Mail under freedom of information laws showed that seven spent more than £10million on private ambulances or taxis last year

Figures from England’s ten ambulance trusts obtained by the Mail under freedom of information laws showed that seven spent more than £10million on private ambulances or taxis last year

At the North East Ambulance Service, private vehicles responded to 2,943 category one calls for patients in a life-threatening condition such as cardiac or respiratory arrest last year – twice as many as in 2019/20.

Stephen Segasby, the trust’s chief, said: ‘Private ambulance services are often brought in to support and protect our service for patients during surges in demand – most recently as a result of winter, the pandemic, pressures across the NHS and for periods of industrial action. All private ambulance companies used by us are subject to a robust procurement process.’

An NHS spokesman said: ‘Ambulance service staff have worked incredibly hard in challenging circumstances since the beginning of the pandemic, and making use of qualified staff and appropriate vehicles in the voluntary and independent sector, is one way in which local teams can balance local emergency care demand.’

Ambulance response times in England were the worst on record in December as the NHS buckled under the strain of a tough winter with flu, coronavirus and norovirus cases.

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