Emergency medical services in the United Kingdom
Emergency medical services in the United Kingdom provide emergency care to people with acute illness or injury and are predominantly provided free at the point of use by the four National Health Services of England, Scotland and Northern Ireland. Emergency care including ambulance and emergency department treatment is free to everyone, regardless of immigration or visitor status; the NHS commissions most emergency medical services through the 14 NHS organisations with ambulance responsibility across the UK. As with other emergency services, the public access emergency medical services through one of the valid emergency telephone numbers. In addition to ambulance services provided by NHS organisations, there are some private and volunteer emergency medical services arrangements in place in the UK, the use of private or volunteer ambulances at public events or large private sites, as part of community provision of services such as community first responders. Air ambulance services in the UK are not part of the NHS and are funded through charitable donations.
Paramedics are seconded from a local NHS ambulance service, with the exception of Great North Air Ambulance Service who employ their own paramedics. Doctors are provided by their home hospital and spend no more than 40% of their time with an air ambulance service. Public ambulance services across the UK are required by law to respond to four types of requests for care, which are: Emergency calls Doctor's urgent admission requests High dependency and urgent inter-hospital transfers Major incidentsAmbulance trusts and services may undertake non-urgent patient transport services on a commercial arrangement with their local hospital trusts or health boards, or in some cases on directly funded government contracts, although these contracts are fulfilled by private and voluntary providers; the National Health Service Act 1946 gave county and borough councils a statutory responsibility to provide an emergency ambulance service, although they could contract a voluntary ambulance service to provide this, with many contracting the British Red Cross, St John Ambulance or another local provider.
The last St John Division, to be so contracted is reputed to have been at Whittlesey in Cambridgeshire, where the two-bay ambulance garage can still be seen at the branch headquarters. The Regional Ambulance Officers’ Committee reported in 1979 that “There was considerable local variation in the quality of the service provided in relation to vehicles and equipment. Most Services were administered by Local Authorities through their Medical Officer of Health and his Ambulance Officer, a few were under the aegis of the Fire Service, whilst others relied upon agency methods for the provision of part or all of their services.” The 142 existing ambulance services were transferred by the National Health Service Reorganisation Act 1973 from local authority to central government control in 1974, consolidated into 53 services under regional or area health authorities. This led to the formation of predominantly county based ambulance services, which merged up and changed responsibilities until 2006, when there were 31 NHS ambulance trusts in England.
The June 2005 report "Taking healthcare to the Patient", authored by Peter Bradley, Chief Executive of the London Ambulance Service, for the Department of Health led to the merging of the 31 trusts into 13 organisations in England, plus one organisation each in Wales and Northern Ireland. Following further changes as part of the NHS foundation trust pathway, this has further reduced to 10 ambulance service trusts in England, plus the Isle of Wight which has its own provision. Following the passage of the Health and Social Care Act 2012, commissioning of the ambulance services in each area passed from central government control into the hands of regional clinical commissioning groups; the commissioners in each region are responsible for contracting with a suitable organisation to provide ambulance services within their geographical territory. The primary provider for each area is held by a public NHS body, of which there are 11 in England, 1 each in the other three countries. In England there are now ten NHS ambulance trusts, as well as an ambulance service on the Isle of Wight, run directly by Isle of Wight NHS Trust, with boundaries following those of the former regional government offices.
The ten trusts are: East Midlands Ambulance Service NHS Trust East of England Ambulance Service NHS Trust London Ambulance Service NHS Trust North East Ambulance Service NHS Foundation Trust North West Ambulance Service NHS Trust South Central Ambulance Service NHS Foundation Trust South East Coast Ambulance Service NHS Foundation Trust South Western Ambulance Service NHS Foundation Trust West Midlands Ambulance Service University NHS Foundation Trust Yorkshire Ambulance Service NHS TrustThe English ambulance trusts are represented by the Association of Ambulance Chief Executives, with the Scottish and Northern Irish providers all associate members. On the 14 November 2018 West Midlands Ambulance Service became the UK's first university-ambulance trust; the service was operated before reorganisation in 1974 by the St Andrews’ Ambulance Association under contract to the Secretary of State for Scotland. The Scottish Ambulance Service is a Special Health Board that provides ambulance services throughout whole of Scotland, on behalf of the Health and Social Care Directorates of the Scottish Government.
Due to the remote nature of many areas of Scotland compared to the other Home Nations, the Scottish Ambulance Service has Britain's only publi
Dolgellau is a market town and community in Gwynedd, north-west Wales, lying on the River Wnion, a tributary of the River Mawddach. It is traditionally the county town of the historic county of Merionethshire, which lost its administrative status when Gwynedd was created in 1974. Dolgellau is the main base for climbers of Cadair Idris; the site of Dolgellau was, in the pre-Roman Celtic period, part of the tribal lands of the Ordovices, who were conquered by the Romans in AD 77–78. Although a few Roman coins from the reigns of Emperors Hadrian and Trajan have been found near Dolgellau, the area is marshy and there is no evidence that it was settled during the Roman period. There are, three hill forts in the vicinity of Dolgellau, of uncertain origin. After the Romans left, the area came under the control of a series of Welsh chieftains, although Dolgellau was not inhabited until the late 11th or 12th century, when it was established as a "serf village" by Cadwgan ap Bleddyn — it remained a serf village until the reign of Henry Tudor.
A church was built in the 12th century, although Cymer Abbey, founded in 1198 in nearby Llanelltyd, remained the most important religious centre locally. Dolgellau gained in importance from this period onwards, was mentioned in the Survey of Merioneth ordered by Edward I. In 1404 it was the location of a council of chiefs under Owain Glyndŵr. After a visit by George Fox in 1657, many inhabitants of Dolgellau converted to Quakerism. Persecution led a large number of them to emigrate to Pennsylvania in 1686, under the leadership of Rowland Ellis, a local gentleman-farmer; the Pennsylvanian town of Bryn Mawr, home to a prestigious women's liberal arts college, is named after Ellis's farm near Dolgellau. The woollen industry was long of the greatest importance to the town's economy; the industry declined in the first half of the 19th century, owing to the introduction of mechanical looms. Another important contributor to the local economy was tanning, which continued into the 1980s in Dolgellau, though on a much reduced scale.
The town was the centre of a minor gold rush in the 19th century. At one time the local gold mines employed over 500 workers. Clogau St. David's mine in Bontddu and Gwynfynydd mine in Ganllwyd have supplied gold for many royal weddings. Dolgellau was the county town of Merionethshire until 1974 when, following the Local Government Act of 1972, it became the administrative centre of Meirionnydd, a district of the county of Gwynedd; this was abolished in 1996 by the Local Government Act 1994. Today, the economy of Dolgellau relies chiefly on tourism, it is believed that Dolgellau Cricket Club, founded in 1869 by Frederick Temple, is one of the oldest cricket clubs in Wales. For nearly a century Dolgellau was the home of Dr Williams School, a pioneering girls' secondary school; this was funded from the legacy of Daniel Williams the Welsh nonconformist of the 17th/18th century. The name of the town is of uncertain origin, although dôl is Welsh for "meadow" or "dale", gelli means "grove" or "spinney", is common locally in names for farms in sheltered nooks.
This would seem to be the most derivation, giving the translation "Grove Meadow". It has been suggested that the name could derive from the word cell, meaning "cell", translating therefore as "Meadow of cells", but this seems less considering the history of the name; the earliest recorded spelling is "Dolkelew", although a spelling "Dolgethley" dates from 1285. From until the 19th century, most spellings were along the lines of "Dôlgelly" "Dolgelley", "Dolgelly" or "Dolgelli". Thomas Pennant used the form "Dolgelleu" in his Tours of Wales, this was the form used in the Church Registers in 1723, although it never had much currency. In 1825 the Registers had "Dolgellau", which form Robert Vaughan of Hengwrt adopted in 1836. While this form may derive from a false etymology, it became standard in Welsh and is now the standard form in both Welsh and English, it was adopted as the official name by the local rural district council in 1958. Shortly before the closure of the town's railway station it displayed signs reading variously Dolgelly and Dolgellau.
Dolgellau is home to Coleg Meirion-Dwyfor. The site it occupies was home to Dr Williams' School, a direct grant grammar school for girls aged 7–18 established in 1875, it was named after its benefactor Dr Daniel Williams, a Nonconformist minister from Wrexham, who gave his name to Dr Williams's Library in Euston, London. The school closed in 1975. Dolgellau Grammar School, a boys' school, had been established in 1665 by the Rector of Dolgellau, Dr John Ellis, at Pen Bryn, before moving to its present site on the Welshpool road. In 1962, it became a comprehensive school under the name Ysgol y Gader, it has 310 pupils and, according to the latest inspection report by Estyn, it has a GCSE pass rate of 75%, which puts it in joint 11th place in Wales, makes it o
Bronaber is a village in Gwynedd, adjacent to the A470 north of Dolgellau and in Trawsfynydd community. During the Second World War, the War Office used a site near Bronaber up in the Ranges for training exercises. There is a part of a river named after the training area called'Llyn Soldiers' which means'Soldiers Lake' Its continued use for training exercises following the war was the subject of protest by Plaid Cymru, which challenged the UK government's continued military conscription in peace time. Other locations in Wales used for training exercises included Preseli Tregaron; the village has a high proportion of Welsh language speakers, is accordingly in the top five Welsh communities in Gwynedd. In Bronaber there is a holiday village used by tourists every year to stay in Snowdonia, there are 200 lodges in Bronaber and most of them occupied every year until November. In Bronaber there is a shop, a bar and restaurant, a chapel, a launderette, a letter box and a phone booth. There is a lake in Bronaber called Llyn Llygain, referred as Llyn Pikes, this is because there were pikes in the lake that people used to fish, but several believe that most of them have gone
National Eisteddfod of Wales
The National Eisteddfod of Wales is the most important of several eisteddfodau that are held annually in Wales. Its eight days of competitions and performances are considered the largest music and poetry festival in Europe. Competitors number 6,000 or more, overall attendance exceeds 150,000 visitors; the 2018 Eisteddfod was held in Cardiff Bay. The National Museum of Wales says that "the history of the Eisteddfod may traced back to a bardic competition held by the Lord Rhys in Cardigan Castle in 1176", Local Eisteddfodau have been held for many years prior to the first national Eisteddfod. There have been multiple Eisteddfodau held on a national scale in Wales, such as the Gwyneddigion Eisteddfod of 1789, the Provincial Eisteddfodau from 1819-1834, the Abergavenny Eisteddfodau of 1835-1851, The Great Llangollen Eisteddfod of 1858, but the National Eisteddfod of Wales as an organisation traces its history back to the first event held in 1861, in Aberdare. One of the most dramatic events in Eisteddfod history was the award of the 1917 chair to the poet Ellis Humphrey Evans, bardic name Hedd Wyn, for the poem Yr Arwr.
The winner was announced, the crowd waited for the winner to stand up to accept the traditional congratulations before the chairing ceremony, but no winner appeared. It was announced that Hedd Wyn had been killed the previous month on the battlefield at Passchendaele in Belgium; these events were portrayed in the Academy Award nominated film Hedd Wyn. In 1940, during the Second World War, the Eisteddfod was not held, for fear that it would be a bombing target. Instead, the BBC broadcast an Eisteddfod radio programme, the Chair, Crown and a Literature Medal were awarded. In 1950 a new rule was created. However, settings of the mass in Latin are allowed and this has been controversially used to allow concerts featuring international soloists. In recent years efforts have been made to attract more non-Welsh speakers to the event, with the officlal website stating "everyone is welcome at the Eisteddfod, whatever language they speak"; the Eisteddfod offers bilingual signage and simultaneous-translation of many events though wireless headphones.
There is a Welsh-learners area called Maes D. These efforts has helped increase takings, the 2006 Eisteddfod reported a profit of over £100,000, despite costing £2.8m to stage. The Eisteddfod attracts some 160,000 people annually; the National Eisteddfod in Cardiff drew record crowds, with over 160,000 visitors attending. It is proposed that the 2018 National Eisteddfod in Cardiff will use permanent buildings to host events rather than in the traditional Maes and tents; this is due to a lack of suitable land that can be repaired affordably after the festival. It has been billed as an "Eisteddfod with no fence" in the media and is planned to take place at Cardiff Bay; the Eisteddfod of 2019 is planned to return to the traditional Maes. The National Eisteddfod is traditionally held in the first week of August, the competitions are all held in the Welsh language. However, settings of the mass in Latin are allowed and this has been controversially used to allow concerts featuring international soloists.
The venue is proclaimed a year in advance, at which time the themes and texts for the competitions are published. The organisation for the location will have begun a year or more earlier, locations are known two or three years ahead; the Eisteddfod Act of 1959 allowed local authorities to give financial support to the event. Traditionally the Eisteddfod venue alternates between south Wales; the Eisteddfod has been held in England, although the last occasion was in 1929. Hundreds of tents and booths are erected in an open space to create the maes; the space required for this means that it is rare for the Eisteddfod to be in a city or town: instead it is held somewhere with more space. Car parking for day visitors alone requires several large fields, many people camp on the site for the whole week; the festival has a quasi-druidic flavour, with the main literary prizes for poetry and prose being awarded in colourful and dramatic ceremonies under the auspices of the Gorsedd of Bards of the Island of Britain, complete with prominent figures in Welsh cultural life dressed in flowing druidic costumes, flower dances, trumpet fanfares and a symbolic Horn of Plenty.
However, the Gorsedd is not an ancient institution or a pagan ceremony but rather a romantic creation by Iolo Morganwg in the 1790s, which first became a formal part of the Eisteddfod ceremonial in 1819. It is taken seriously, an award of a crown or a chair for poetry is a great honour; the Chairing and Crowning ceremonies are the highlights of the week, are presided over by the Archdruid. Other important awards include the Prose Medal. If no stone circle is there one is created out of Gorsedd stones taken from the local area; these stone circles are icons all across Wales and signify the Eisteddfod having visited a community. As a cost-saving measure, the 2005 Eisteddfod was the first to use a temporary "fibre-glass stone" circle for the druidic ceremonies instead of a permanent stone circle; this has the benefit of bringing the Gorsedd ceremonies onto the maes: they were held many miles away, hidden from most of the public. As well as the main pavilion with the main stage, there are other
Llyn Trawsfynydd is a large man-made reservoir situated near the village of Trawsfynydd in Gwynedd, North Wales. With a total surface area of 4.8 km² the reservoir is more extensive than Wales's largest natural lake, Bala Lake. The large man-made reservoir was created between 1928 by building four dams, its purpose was to supply water for Maentwrog hydro-electric power station. Although two dozen properties, some of historical significance, were lost in the creation of the lake, there was little local objection at the time. Indeed, the power station was regarded as a good thing because it was capable of supplying the whole of North Wales' electricity needs; however local landowners and farmers did object to the loss of rights of way across their former lands. In order to negate long detours round the new lake, a small road was built along the western shore and a footbridge was erected across the narrowest part of the lake. In 1965 the reservoir became the source for cooling water for the Trawsfynydd nuclear power station which began generating electricity for the UK National Grid.
In respect to this new role, one of the lake's dams was rebuilt in the early 1960s to increase the volume of Llyn Trawsfynydd. This was because of priority over usage. Whereas the Maentwrog power station had taken all of the water in the lake, the needs of the nuclear plant dictated that the hydro plant would only be able to utilise the top 5 ft of water. In 1991 the nuclear power station was shut down, it is now in the process of decommissioning. Work will be completed in 2083. Since the plant's closure, the lake's water temperature has cooled to natural levels allowing fauna and flora to regenerate. Water continues to be used for hydroelectricity generation. Official Site
Plaid Cymru is a social-democratic political party in Wales advocating Welsh independence from the United Kingdom within the European Union. Plaid was formed in 1925 and won its first seat in the UK Parliament in 1966. By 2018, it held one of four Welsh seats in the European Parliament, four of 40 Welsh seats in the UK Parliament, 10 of 60 seats in the National Assembly for Wales, 202 of 1,264 principal local authority councillors. Plaid is a member of the European Free Alliance. Plaid Cymru's goals as set out in its constitution are: To promote the constitutional advancement of Wales with a view to attaining independence within the European Union. In September 2008, a senior Plaid assembly member spelled out her party's continuing support for an independent Wales; the Welsh Minister for Rural Affairs, Elin Jones, began Plaid's annual conference by pledging to uphold the goal of making Wales a European Union member state. She told the delegates in Aberystwyth that the party would continue its commitment to independence under the coalition with the Welsh Labour Party.
While both the Labour and Liberal parties of the early 20th century had accommodated demands for Welsh home rule, no political party existed for the purpose of establishing a Welsh government. Plaid Genedlaethol Cymru was formed on 5 August 1925, by Moses Gruffydd, H. R. Jones and Lewis Valentine, members of Byddin Ymreolwyr Cymru. Home rule for Wales was not an explicit aim of the new movement. In the 1929 general election the party contested its first parliamentary constituency, polling 609 votes, or 1.6% of the vote for that seat. The party contested few such elections in its early years due to its ambivalence towards Westminster politics. Indeed, the candidate Lewis Valentine, the party’s first president, offered himself in Caernarvonshire on a platform of demonstrating Welsh people's rejection of English dominion. By 1932, the aims of self-government and Welsh representation at the League of Nations had been added to that of preserving Welsh language and culture. However, this move, the party's early attempts to develop an economic critique, did not broaden its appeal beyond that of an intellectual and conservative Welsh language pressure group.
The alleged sympathy of the party's leading members towards Europe's totalitarian regimes compromised its early appeal further. Saunders Lewis, David John Williams and Lewis Valentine attacked and set fire to the newly constructed RAF Penyberth air base on the Llŷn Peninsula in Gwynedd in 1936, in protest at its siting in the Welsh-speaking heartland; the leaders' treatment, including the trial judge's dismissal of the use of Welsh and their subsequent imprisonment in Wormwood Scrubs, led to "The Three" becoming a cause célèbre. This heightened the profile of the party and its membership had doubled to nearly 2,000 by 1939. Penyberth, Plaid Cymru’s neutral stance during the Second World War, prompted concerns within the UK Government that it might be used by Germany to insert spies or carry out other covert operations. In fact, the party urged conscientious objection to war service. In 1943 Saunders Lewis contested the University of Wales parliamentary seat at a by-election, gaining 1,330 votes, or 22%.
In the 1945 general election, with party membership at around 2,500, Plaid Cymru contested seven seats, as many as it had in the preceding 20 years, including constituencies in south Wales for the first time. At this time Gwynfor Evans was elected president. Gwynfor Evans's presidency coincided with the maturation of Plaid Cymru into a more recognisable political party, its share of the vote increased from 0.7% in the 1951 general election to 3.1% in 1955 and 5.2% in 1959. In the 1959 election, the party contested a majority of Welsh seats for the first time. Proposals to drown the village of Capel Celyn in the Tryweryn valley in Gwynedd in 1957 to supply the city of Liverpool with water played a part in Plaid Cymru's growth; the fact that the parliamentary bill authorising the drowning went through without support from any Welsh MPs showed that the MPs' votes in Westminster were not enough to prevent such bills from passing. Support for the party declined in the early 1960s as support for the Liberal Party began to stabilise from its long-term decline.
In 1962 Saunders Lewis gave a radio talk entitled Tynged yr Iaith in which he predicted the extinction of the Welsh language unless action was taken. This led to the formation of Cymdeithas yr Iaith Gymraeg the same year. Labour's return to power in 1964 and the creation of the post of Secretary of State for Wales appeared to represent a continuation of the incremental evolution of a
National Assembly for Wales
The National Assembly for Wales is the devolved parliament of Wales, with power to make legislation, vary taxes and scrutinise the Welsh Government. The Assembly comprises AMs. Since 2011, Members are elected for five-year terms under an additional members system, in which 40 AMs represent geographical constituencies elected by the plurality system, 20 AMs represent five electoral regions using the d'Hondt method of proportional representation; the largest party in the Assembly forms the Welsh Government. The Assembly was created by the Government of Wales Act 1998, which followed a referendum in 1997; the Assembly had no powers to initiate primary legislation until limited law-making powers were gained through the Government of Wales Act 2006. Its primary law-making powers were enhanced following a Yes vote in the referendum on 3 March 2011, making it possible for it to legislate without having to consult the UK parliament or the Secretary of State for Wales in the 20 areas that are devolved.
Legislation has been introduced by the Assembly Commission which will change the name of the institution from National Assembly for Wales to the Senedd, which may be known as the Welsh Parliament. An appointed Council for Wales and Monmouthshire was established in 1949 to "ensure the government is adequately informed of the impact of government activities on the general life of the people of Wales"; the council had 27 members nominated by local authorities in Wales, the University of Wales, National Eisteddfod Council and the Welsh Tourist Board. A post of Minister of Welsh Affairs was created in 1951 and the post of Secretary of State for Wales and the Welsh Office were established in 1964 leading to the abolition of the Council for Wales; the establishment of the Welsh Office created the basis for the territorial governance of Wales. The Royal Commission on the Constitution was set up in 1969 by Harold Wilson's Labour Government to investigate the possibility of devolution for Scotland and Wales.
Its recommendations formed the basis of the 1974 White Paper Democracy and Devolution: proposals for Scotland and Wales, which proposed the creation of a Welsh Assembly. However, Welsh voters rejected the proposals by a majority of four to one in a referendum held in 1979. After the 1997 general election, the new Labour Government argued that an Assembly would be more democratically accountable than the Welsh Office. For eleven years prior to 1997 Wales had been represented in the Cabinet of the United Kingdom by a Secretary of State who did not represent a Welsh constituency at Westminster. A second referendum was held in Wales on 18 September 1997 in which voters approved the creation of the National Assembly for Wales with a total of 559,419 votes, or 50.3% of the vote. The following year the Government of Wales Act was passed by the United Kingdom parliament, establishing the Assembly. In July 2002, the Welsh Government established an independent commission, with Lord Richard as chair, to review the powers and electoral arrangements of the National Assembly to ensure that it is able to operate in the best interests of the people of Wales.
The Richard Commission reported in March 2004. It recommended that the National Assembly should have powers to legislate in certain areas, whilst others would remain the preserve of Westminster, it recommended changing the electoral system to the single transferable vote which would produce greater proportionality. In response, the British government, in its Better Governance for Wales White Paper, published on 15 June 2005, proposed a more permissive law-making system for the Welsh Assembly based on the use of Parliamentary Orders in Council. In so doing, the Government rejected many of the cross party Richard Commission's recommendations; this has attracted criticism from opposition others. The Government of Wales Act 2006 received Royal Assent on 25 July 2006, it conferred on the Assembly legislative powers similar to other devolved legislatures through the ability to pass Assembly Measures concerning matters that are devolved. Requests for further legislative powers made through legislative competence requests were subject to the veto of the Secretary of State for Wales, House of Commons or House of Lords.
The Act reformed the assembly to a parliamentary-type structure, establishing the Welsh Government as an entity separate from, but accountable to the National Assembly. It enables the Assembly to legislate within its devolved fields; the Act reforms the Assembly's electoral system. It prevents individuals from standing as candidates in regional seats; this aspect of the act was subject to a great deal of criticism, most notably from the Electoral Commission. The Act was criticised. Plaid Cymru, the Official Opposition in the National Assembly from 1999–2007, attacked it for not delivering a fully-fledged parliament. Many commentators have criticised the Labour Party's partisan attempt to alter the electoral system. By preventing regional Assembly Members from standing in constituency seats the party has been accused of changing the rules to protect constituency representatives. Labour had 29 members in the Assembly at the time; the changes to the Assembly's powers were commenced on 4 May 2007, after the election.
Following a referendum on 3 March 2011, the Welsh Assembly gained direct law making powers, without the need to consult Westminster. The Conservative-Liberal coalition government created the Commission on Devolution in Wales