THE critical issue of rural cover has come under the spotlight again this week prompted by concerns over ambulance response times to a blaze in Four Marks.
While fire officers attending the incident (on the evening of Saturday, September 4) were able to administer first aid to a woman who had been hauled out of a burning flat, concern has been expressed over the length of time it took Hampshire Ambulance Service to respond to the call.
The concern was not just for the victim but for the firefighters who were putting their own safety on the line without medical back-up.
It was not a criticism of the ambulance crew which, while based in Alton, were in Basingstoke at the time of the call-out and unable to meet the 19-minute response time, set down by government for category B (non-life threatening) calls.
By way of explanation, Mike Cassidy, director of patient services for Hampshire Ambulance Service NHS Trust said that while the aim was to get to the majority of non-life threatening incidents within 19 minutes, on this occasion it had not been possible.
"It was unfortunate that on this particular occasion we did not manage to reach the patient within this time. This was due to all ambulances and rapid response vehicles in the vicinity responding to other 999 emergency calls," he said.
The incident, however, has served to highlight the continuing failure by management to address the issue of under-resourcing which union members see as the "core problem", responsible for the perpetuation of "postcode lottery" cover.
According to Alton ambulance man Jim Barnett, who is also chairman of the Joint Shop Stewards Committee for Hampshire Ambulance Trust, on Saturday evening there was no way the Alton crew could have crossed Basingstoke, driven down the A339 and across to Four Marks in 19 minutes.
"The journey depends on influencing factors such as weather conditions and the volume of traffic but it usually takes nearer 25 minutes," said Mr Barnett, whose union has been stressing for a long time the need for additional cover in the rural part of north Hampshire.
The area, he said, is losing out due to an ambulance service forced by government targets to concentrate its efforts on urban "hot spots". This is exacerbated locally by the needs of Basingstoke which, being desperately understaffed, is pulling in ambulance crews from Alton, Whitchurch and Winchester leaving the rural communities with inadequate cover.
"While the trade union is happy to concede that active responsibility for providing cover in rural areas has improved, the transportation of sick or injured people to hospital has not," said Mr Barnett.
To clarify the issue Mr Barnett was quick to praise the setting up of a First Responders Group among retained fire crews at Bordon - a pilot project which, if successful, is expected to spread to other stations such as Alton.
Bordon also benefits from a "Steps" programme vehicle which is manned by a paramedic and a fully trained nurse and aims to cut down on the transportation of casualties to hospital by identifying those who can be treated at home.
These initiatives are supported by an HM forces first response Triservice team based at RAF Odiham, and a Rapid Response Vehicle (RRV) which is owned and operated single-handedly and on a 24/7 basis by Alton-based paramedic Nigel Fury.
"Together they can take credit for achieving statistical targets for category A calls (life threatening calls which should be responded to within eight minutes) for the Alton, Bordon, Whitehill, Headley, Grayshott, Liss and Liphook areas.
"But this does not mean that the injured or ill person will get an emergency ambulance to transport them any sooner to hospital," he warned.
There is, however, a funding query hanging over the head of the RRV at Alton. "We just hope, for the sake of people living in the rural areas, that this is given the go-ahead to continue," said Mr Barnett.
While the Alton staffing level is currently at full strength, Jim Barnett believes the station's ability to provide rural cover could be improved by the provision of a high-dependency vehicle, which could be used to transport patients to hospital and for hospital transfers, leaving the two emergency vehicles to concentrate on A and E work.
While believing that management should take the blame for their continuing failure to secure finance and resources needed to improve the situation, Mr Barnett was quick to recognise the problems inherited by chief executive Claire Severgnini and her team. It was a legacy, he said, which they were battling hard to overcome.
However, the fact remains that: "If getting an ambulance when you need one than you do if you live in the countryside and that," said the union chairman, "is simply not good enough."