Ambulance 'business' abandoned: Service hit by computer failure is returned to health authority control

THE GOVERNMENT yesterday abandoned one of its boldest applications of business methods to public services by scrapping the London Ambulance Service board and returning the pounds 70m-a-year service to regional health authority control.

The decision follows a damning report last month from an independent inquiry into management failures leading to the collapse of the ambulance service's pounds 1.5m computer system. Unions said that the delays in dispatching ambulances on emergency calls claimed 20 lives before the computer system finally crashed.

Virginia Bottomley, the Secretary of State for Health, yesterday accepted that the experimental arrangements adopted three years ago for 'arm's length' accountability of the new LAS board to the South West Thames Regional Health Authority had failed.

'Despite the considerable efforts of those concerned, the arrangements left the LAS, the board and the RHA unclear about their respective roles and responsibilities,' the minister wrote in a letter to Professor Marian Hicks, the regional health authority's chairman. 'The accountability arrangements . . . were inefficient.'

Under the new arrangements, which take effect from May, a regional health authority committee will take over responsibility for the LAS from the board.

Martin Gorham, the new LAS chief executive, becomes accountable directly to Chris Spry, the South West Thames regional general manager, whose own salary will depend partly on the performance of the ambulance service. There will be regular reports for community health councils, Parliament and councils and twice-yearly meetings between management and ambulance union leaders. A team of specialists on accident and emergency practice and information technology will soon be appointed to advise both the LAS and health region managers.

London's ambulance response times - thought to be among the worst in the UK - will also be monitored and published quarterly by the region. Mr Gorham disclosed yesterday that since the computer system crashed last November, the LAS had lost contracts for non-emergency ambulance work to competing ambulance services in the new NHS internal market.

The LAS had still not reinstated the computer system and all operations were being carried out manually, he said. Chris Webb, a member of the independent inquiry team, had been appointed as acting LAS director of information technology. Mr Webb will shortly recommend whether the computer system should be re-introduced.

'There is no question of putting in a new system,' said Mr Gorham, who succeeded John Wilby as chief executive in a management shake-up following the computer collapse.

David Blunkett, Labour's health spokesman, welcomed the Government's decision to acknowledge a major failure in applying the 'arm's length' principle to the management of an NHS service.