David Wells reports on the proposed merger of ambulance services in Sussex and Kent and asks whether it will provide better patient care as promised.

Ambulance authorities say patients would benefit from a merger of services.

They argue one giant supertrust, formed out of Sussex Ambulance Service NHS Trust and Kent Ambulance Service, could make a larger, more cost-effective bid for the best equipment and modern communication systems.

This would create a pool of resources for the benefit of all.

Bosses think this would enable authorities to prioritise more efficiently, for example only sending emergency units to emergency cases and reserving other vehicles for when patients need to be taken to a GP.

Martyn Long, however, a former chairman of the Sussex service, has said it would mean redundancies and a poorer service in rural areas.

He said a merger would leave such areas open to neglect and falling response times as the giant trust threw more resources at larger urban areas where the majority of the population was concentrated.

Mr Long, who was chairman of Sussex Ambulance Service for four years, oversaw the merger of East and West Sussex ambulance services in 1995.

He said that move was sensible because it united two parts of the same county but he believes there will be no benefits for residents if the proposed merger goes ahead.

"Other than a small saving initially on management costs, savings will be far outweighed by costs of the redundancies caused by the merger.

"Sussex Ambulance Service and Kent Ambulance Service have totally different and non compatible control and communications systems.

"Unless there is one communication system for both counties, there cannot be a true merger.

"Thus there will still have to be two systems for some years to come.

"Sussex has invested in new control systems within the last few years, which will be wasted if a merger takes place and a single communication system installed.

"Also, why is it necessary to go through a further merger when Sussex is just settling down from the 1995 merger of East and West Sussex services?

"The priority dispatch systems of the two services are again totally different. So, with one new service, retraining will have to take place, adding costs.

"Also, the two present services have different pay systems which will mean costs will have to be increased as the higher rate system will have to apply throughout.

"A further merger will simply have a demoralising effect on staff who have to deliver the service."

David Griffiths, chief executive of the Sussex ambulance service, said the changes would be at a management and administrative level to provide a better service to patients and were not based on economic considerations.

He said the consultation document about the merger had never said there would be large savings as a result of the move but that it would give faster, more consistent and better quality care.

He said: "The role of the ambulance service has to change. It has to provide for a greater range of options to a call than it does now.

"Taking people to an accident and emergency department only to be told they do not need to be there is clearly not working and it is clogging up the system.

"We need to be able to provide better, clinically- trained people over a larger area in order to get patients more effectively to the care they need, whether this is GPs, intensive therapy or emergency treatment."

The NHS wants to create three new ambulance trusts for the South-East region.

Apart from the Sussex and Kent proposals, plans have been discussed to combine Hampshire with Surrey and Buckinghamshire, while Northamptonshire is planned to merge with Oxfordshire and Berkshire.

Leaders of ambulance services in the region have been working together to create a joint vision of their role in the future and have said particular emphasis will be put on strong local identities.

Mr Griffiths said the details of the scheme were still open to debate.

The trusts have said there were no plans to close stations or cut staff numbers. Under the proposals crews would continue to operate in the same county.

The main decision to be made was where the new trust headquarters would be based.

Once the consultation was complete, the results would be discussed and considered before a final draft was sent to Health Secretary Alan Milburn for approval.