THE FIASCO of the London Ambulance Service which has brought the resignation of its chief executive is much more than a computer cock-up.
The chaos in LAS emergency services brought the death of an estimated 20 patients in 36 hours, and many more before: but it flows from years of under-funding, made much worse by the ludicrous "business methods' imposed by the Tory health reforms.
Disgraced chief executive John Wilby was hand-picked for the job in 1990, after a career including a stint as a manager in South Africa. He ushered in a restructuring of LAS which created a new Board of Directors and massively expanded management ranks while the jobs of front-line ambulance staff were axed.
Accountants
The Board replaced the traditional uniformed chief officers with a platoon of directors on £30,000 plus salaries and no less than 19 additional top managers and accountants. At the same time a total of 300 non-emergency posts (over a third) were deleted, forcing a reduction of over 10 percent in patient journeys, and repeated crises in which emergency crews and vehicles were diverted to pick up patients left stranded.
Refusing to meet with or discuss with unions, Wilby's new-look management forged recklessly ahead, learning nothing from experience on the ground One disastrous computerised svstem which had cost £7.5 million but failed to work since 1983 was replaced ... with another, completely untested system costing £1.5m.
Converted vans
Wilby announced that the LAS would buy not custom-built ambulances but converted Leyland-DAF vans to save just £3,000 per vehicle: union objections to the poor specifications of the vehicles were ignored. And despite a clapped out fleet of 999 ambulances, Wilby axed eight of the 18 repair WOrKSnOOS Chasing a 'high-tec' image, the LAS splashed out £2.3m a year and assigned scarce paramedic staff to a controversial helicopter and 'instant response unit: last year the helicopter carried just one patient a day, while over 1,900 other emergency patients a day waited an average of 26 minutes for an ambulance.
Behind the public relations facade, the LAS performance plummeted under the new management.
In 1990 just 74% of 999 calls saw LAS ambulances activated within 3 minutes compared with a government target of 95%. fallen to 49%, and in early 1992 it was only 30%!
In 1990, a mere 76% of LAS ambulances arrived within 14 minutes of a 999 call, against government target of95%: by 1991 this was down to 66%, and in 1992 it fell to 59%.
The new computer system was the final straw that brought the emergency service to the point of collapse. It was introduced without testing, without proper staff training, and in two stages instead of three. The computer immediately showed an ability to lose calls and malfunction.
No confidence On April 3 1992 the 500 LAS staff working the system in NE London sent the Board a formal vote of no conPHOTO: Andrew Wiard Not happy: Major's man in Europe, Douglas Hurd Italian pensioners - threatened by Maastricht
ces have to be made. Choices made now ruling class was dominant. A high-