The Daily Telegraph

Editorial Comment

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Ambulance services are about to undergo their biggest shake-up since the reorganisa­tion of the NHS in 1973, in an effort to make sure that people who really have emergencie­s are more likely to get taken to hospital faster. Instead of half of all 999 calls being classified as requiring a super-fast response, in future just 8 per cent will be treated so expeditiou­sly.

A four-minute telephone triage procedure, of the sort that is used for the non-emergency 111 hotline, will determine which cases need an immediate call-out. NHS chiefs insist that these changes will save lives, because the sickest patients will get urgent treatment more quickly. But inevitably some people will fall through the cracks, with fatal consequenc­es.

The target obsession in the NHS has led to the inefficien­t dispatch of ambulances and caused so-called hidden waits for hospital places. For heart attack or stroke victims, the margins between life and death can be measured in minutes. But if the state cannot guarantee an emergency response, it has no right to stop the developmen­t of alternativ­es that can. There is no obvious reason why ambulances should be operated by the NHS, directly or under contract. If it is possible with modern technology to summon up an Uber taxi in five minutes, why not private emergency transport to a hospital?

Moreover, why don’t other blue-light services, such as the fire brigade, offer an emergency medical response as they do in France? The unions here have resisted integratio­n, but successful local pilot schemes should be extended nationwide. Rather than turn the NHS into a life-or-death lottery, it is time to rethink the way it is structured.

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