Improving our emergency services

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This would take a burden off accident and emergency, since staff doctors would not be dealing with such a large number of patients. More importantly, it would benefit patients themselves. The last thing many invalids need is a lengthy stay in a waiting room.

ECPs are trained to the same level as a senior nurse. They can take blood samples, prescribe drugs and treat conditions such as asthma and diabetes. These "super-medics" will also be taught to stitch wounds, perform diagnostic tests, and prescribe a wider range of medications. There will be even more scope for these emergency response medics to treat people in their own homes in future.

The 600 ECPs working in England at present have proved their worth. Travelling by car or motorcycle, ECPs tend to arrive quicker than ambulances. And they can often do more for a patient than an ambulance crew. For example, if an elderly person has a fall, but refuses to go to hospital, there is not much an ambulance crew can do, aside from getting the patient back on his or her feet. But a skilled ECP can perform a more complete medical examination, on the spot.

Unison, the union that represents many ambulance drivers, has warned the Government against approaching this as a cost-cutting exercise. But there is no evidence that this is the Department of Health's goal, and it deserves the benefit of the doubt. It should be noted that there are no plans to reduce the number of fully equipped ambulances.

The other fear is of a potentially fatal misdiagnosis over the phone. It has been suggested that a telephone operator might send an ECP when an ambulance is required. This would be dangerous – and the public has a right to expect an emergency system that errs on the side of caution. But the experience of the NHS Direct helpline shows that this is exactly what it does. If NHS Direct advisers are in doubt, they advise a hospital visit. There is no reason to believe emergency service operators will not be equally cautious under the new system.

ECPs are skilled, efficient and safe. They have a substantial role to play in a modern health service.

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