Letter: NHS efficiencies

The proposal by Michael Matheson of the Holyrood Health Committee that NHS 24 should fully merge with the Ambulance Service would turn the clock back to when some ambulance services, notably the West Midlands Ambulance Service, did manage the equivalent of NHS 24 – NHS Direct.

There was disquiet then, not only about the wasteful duplication of management and resources, but also about removing hundreds of nurses from front-line nursing. The emergence of paramedics as degree-level emergency care practitioners means they may treat some patients at home, thus reducing the need for hospital admissions.

This makes them eminently qualified to triage medical calls, derived from operational experience at the sharp end of the organisation.

(Their development should also not have been lost when recently commissioning a medical retrieval service that takes scarce consultants away from the hospital setting.)

Since the services are in the same building such a merger would produce immediate savings and improved efficiency.

Those who fear such mergers should be reassured by the Scottish Ambulance's world-class reputation. This includes one of the UK's first Helicopter Emergency Medical Services – and still the only fully government-funded one – and journey scheduling technology that is unequalled by many large public and commercial organisations.

Significantly, at the moment, its long history demonstrates to its sister emergency services that a single organisation for Scotland can produce economies of scale while remaining sensitive, flexible and responsive to the needs of people locally.

John Wilby

Former chief executive

Scottish and London Ambulance Services

Oakshaw Street

West Paisley