Allowing primary care groups to commission emergency ambulance services would drive up costs, increase bureaucracy, hamper performance and fragment the service, ambulance managers have warned.
In its response to the NHS Executive's consultation paper on commissioning specialised services, the Ambulance Service Association also claims that NHS Executive proposals to transfer responsibility for purchasing 999 services from health authorities to PCGs would require investment in more paramedics and vehicles.
'With the overriding desire to avoid fragmentation, inefficiency and inequity of service delivery, and an increase in bureaucracy, we strongly argue that the commissioning of emergency ambulance services should be led by health authorities,' it says.
The consultation paper ignores 'the operational and economic position' of NHS ambulance services, says the ASA, and devolving 999 purchasing to PCGs could potentially hamper the ability of a service to respond to major disasters.
'The practical and managerial implications of planning and co-ordinating such a response using resources from multiple PCG areas will be considerable and will have real potential for conflict,' it says.
It would also increase bureaucracy by increasing the numbers of contracts and would nullify any financial and qualitative benefits produced by the service mergers of the last few years, says the ASA.
It points out that in the past the NHS Executive decided against allowing GP fundholders to commission emergency ambulance services, and argues that the same principles apply to PCGs.