Air Ambulances Funded by Charity – Good or Bad ?

We've all been held up on the motorway at some point by a smash where the Air Ambulance has had to attend. In general, I think we all appreciate their existence, and are re-assured that they’re there for us if we need whipping off to hospital quickly in a life threatening condition. Statistics show that one air ambulance takes off somewhere in Britain every 10 minutes during daylight hours, and continue to do so without most of us knowing very much at all about how they operate or who pays for them.

What a lot of people aren't aware of is that like the RNLI and Mountain Rescue; this wonderful service isn't state funded but funded by charitable donations to each unit. My initial reaction to this was “Whoa! - Why is a life-saving service not provided for by the state yet the likes of Police helicopters are?” But then I started to think about it and began to realise maybe it is better kept away from the state. To arrive at this conclusion I needed to do some digging and came up with quite a few facts. 

The Facts

Historically, over the last 20 or so years, air ambulances have been set up across the country with no overall planning, no agreed funding and no clear, bespoke system of regulation. As a result, there is an imbalanced patchwork of services, heavily skewed towards southern England, all relying to a major degree on charitable donations.

According to Wikipedia, there are twenty-seven air ambulance services in the United Kingdom using either helicopters or fixed-wing aircraft. Thirty-six helicopters operated by commercial companies and funded by charitable organisations, cover England and Wales. Scotland however is different; they have two helicopters and two planes operated by the Scottish Ambulance Service, whose air wing is the only publicly funded air ambulance in the UK.

Rather like hospices, which on average get a third of their income from the government, air ambulances have developed alongside the NHS, but are complementary to it. We are talking here primarily about "Hems", helicopter emergency medical services, which airlift casualties to hospital. However, the precise role of the individual services varies widely. London's Air Ambulance responds only to major trauma incidents, whereas other services will fly to "retrieve" people who have suffered heart attacks or broken bones and will undertake inter-hospital transfer. Most carry only a paramedic, but the London service always has a doctor too. In 2013, the solitary London Air ambulance attended 1,819 “Patient Missions”, that’s five a day on average.

The charities/air ambulances are represented by two umbrella organisations, the Association of Air Ambulances and the Air Ambulance Service (AAS). The AAS's extensive fundraising – it has over 30 charity shops - means that it pays for everything it does. From the moment it is called on by ambulance control, it says, no cost falls on the NHS. Most other charities rely on paramedics provided by the local ambulance services with which they work, or get all their drugs and equipment from them, while some simply fundraise to lease a helicopter for the NHS.

Indirect Subsidy

London's Air Ambulance, which in the past has had sponsorship from Express Newspapers and Virgin, had 18 personnel seconded from the NHS in 2011-12 at a value of more than £1.2m. In addition, the charity received an NHS grant of almost as much again, representing more than a third of its cash income. This appears true of other air ambulances so they’re not entirely charity funded even if it is through an indirect route. From what I can tell therefore, The Department of Health do pay for the clinical staff on the helicopters but not for the pilots or the running costs, this is what the charity side pays for.

Should it be State funded?

My initial reaction to this question was ‘Yes’ however, thinking about it more, they’re a well-oiled money raising operation as it stands. With so many people voluntarily giving their money to an organisation like the Air Ambulances, why would the Government replace that funding with a tax to fund them?

The other side is, if they were government funded, they would come under the same austerity measures as the rest of the emergency services, we would be talking about which units are going to close down whilst ministers would be standing up saying that response times would not suffer during the cuts!

At the moment, even with charity money showing a tendency to slow, the UK air ambulances are in a pretty good shape and appear to have survived the downturn looking like they should hopefully come out the other side without cuts, which is more than the likes of the Fire Services can say.

In general, (depending on how many helicopters are operated) each air ambulance service needs £2.5m - £5.0m funding a year through charity. This equates to around a £100m nationally and they seem to be achieving it. Bringing this into state funding would see that £100m come out of the NHS budget thus causing more cuts in direct service as the money is diverted away from the Trusts. Therefore it seems eminently sensible that as long as people are donating and the service isn't failing then it should remain outside of the government’s clutches.

North West Air Ambulance

I couldn't write this piece without giving a push for my local air ambulance.

The North-west Air Ambulance which has been flying life-saving missions throughout the region since 1999. They operate three helicopters flying seven days a week, 365 days a year from bases at Royal Preston Hospital and Wythenshawe Hospital; they cover 5,500 square miles and a population of around eight million people. On average the North West Air Ambulance is called out five times a day, rising up to ten in the summer. It costs in excess of £4.2 million per year to maintain both aircraft, but with almost no central government or lottery funding, they rely on the generosity of donors. If you want to donate, you can do it here -  https://nwaa.net/donate