A Real Emergency

Let me paint you a little a picture. We had just taken a 97 year old to hospital. This 97 year old had just fallen down 17 stairs from top to bottom. She had a head injury, she had a broken wrist and she had broken ribs. She didn't want to go to hospital. She didn't want to call an ambulance. She did, because she couldn't get herself up. She apologised 12 times whilst in our presence for getting us out and wasting our time when we could be dealing with REAL emergencies. It took a lot of convincing to get her to agree to hospital and despite the pain she was in she felt she was burden. She had lived through 2 world wars. She had been employed full time from the age of 14 to 75. That's 61 years of taxes and national insurance since its inception. She has no carers at all and still does her own shopping. She costs the country her Freedom Pass and her medication which consisted of a daily Aspirin. She really was an inspiration. We left her at hospital to go and do a REAL emergency.

"25 year old female, pain in back after carrying baby and changing nappy"

What is there to say? I could rant about this for 10, 000 for even needing a breath, but I won't. I will not pass judgment, I will not share my thought. I was just explain what happened, what was said and what we did. Then, I will open it to the floor!

We arrived on scene at the patients flat. It was a council flat. 3 bedrooms. Nice kitchen. HUGE TV in the living room. Ashtray on the coffee table full of fag buts. Childs dummy 6" away. We had let ourselves in as the door was ajar. Sitting on the reclining black leather sofa was our patient. She had a pain'd expression across her face. Jeremy Kyle was on the TV (I'm being serious).

"Hello my dear, what's the problem today?"

"My back hurts."

"Where about?"

"Right here" she said, rubbing her lower back.

"When did it start?"

"About half an hour ago?"

"And what were you doing when it came on?"

"I'd been carrying me baby round and then put her down to change her and as I leaned down it started hurting real bad."

"Do you suffer with back problems?"

"Nah"

"Have you taken any painkillers?"

"Nah"

"It sounds muscular, you may have strained it slightly, what would you like to do today?"

"Go up hospital to get it checked out."

"I don't think hospital is necessary. You can probably treat it at home with pain killers and rest. Hospitals aren't the best place for babies, especially as they will probably tell you what i'm suggesting."

"Nah, i'd sooner go up there and get it checked out."

So that's what we did. She got all her stuff together and we headed out to the ambulance. As we were walking down the stairs her boyfriend / partner arrived. He followed us up to hospital in his car. It was a 2011 BMW with a personalised number plate. He lived at the same address. 

In the ambulance I established she was normally fit and well. No medical history to speak of. No allergies. She smokes 20-30 a day. She is unemployed. Her partner is also unemployed. We arrived at hospital, handed over to the nurse and were promptly sent to the waiting room.

So, for a change I will refrain from saying too much and leave it there!  That is for YOU, my readers to do! Thoughts on a postcard please! 

Elementary, Dear Right Honourable Ann Widdecombe

I may be late to the party but I felt it was time to come out of hiding to have a good old fashioned rant!

So, Richard Madeley of Richard and Judy fame managed to get the backs up of every single ambulance worker in the country with his badly written, badly researched tripe of an editorial about a crew who finished their break before going to the aid of a critically ill child. For those not aware the original story can still be found here. It should have come as no surprise when the article vanished, but it didn't take long for more of the gutter press to spread lies and mis-information and make slanderous, biased attacks on ambulance services and their staff. Why let the truth get in the way of a perfectly good story eh?! It seems to serve no other purpose other than to blacken our name and tarnish the public perception of the NHS as a whole and only goes to make a hard and volatile job just that little bit harder. This time we have The Right Honourable Ann Widdecombe to thank for providing us with one of the worst examples of 'journalism' I have ever seen.

"A BABY of eight weeks is facing possible disability for life as a result of an ambulance crew finishing its break before going on a 999 call."

Belittling the work of the ambulance, police and fire is a right giggle.....

I agree with what she starts with, 'I can think of few more genuine emergencies than a baby having a 'heart attack'. Neither can I. Unfortunately the cardiac arrest the poor child suffered is not the same as a heart attack; never has been, never will be, but that really is beside the point. The child was critically ill and should have had an ambulance quicker than 41 minutes. Why though was West Midlands Ambulance service solely reliant on a crew who was on a rest break? Obviously Mrs Widdecombe couldn't possibly blame the Tory cuts, must tow the party line after all (even when you've retired from office). We can't for a minute blame the lack of funding, not enough staff, not enough ambulances and too many calls for the delay can we?! Oh no... blame the greedy paramedics stuffing their faces ignoring cries for help from a dying baby.

She goes onto draw parallels between staff having the right to a rest break with babies having the right to live. In all seriousness, what does she expect?! Is this the Conservative ideal?! Ambulance crews working 12 hour shifts without the possibility of a break? What happens when we have finished our shift? Does she expect us to answer calls then too? What about before? Do we sign on when we wake up in the morning and offer to answer calls in our own cars? I'm sure she was never advised to starve herself for 12 hours at a time whilst on Celebrity Fit Club....

One of my favourite parts of the article was when she led with 'Members of that crew had better pray that if they ever need to call out the emergency services they don’t find themselves in a clash with a copper’s cuppa or a fire fighter’s elevenses.' It would have only taken asking one member of an ambulance crew to find out how rest breaks work. We have no idea what jobs are going on around us. We are dispatched by a computer (that computer's sole purpose is to assist us meet the government targets), and on the rare occasion we get a break at all, that computer makes us unavailable for that period and we cannot be sent a call. Does she really think that a crew would knowingly sit down and eat in the knowledge that a baby was in cardiac arrest around the corner? I think its disgusting to level such an unfounded accusation at a crew. As for interrupting elevenses, we all know that Trumpton are always at rest!!

As if that wasn't enough she went on.......

"It is bad enough when public servants worry more about their own safety than that of the public and refuse to enter 2ft of water or to hop on a bicycle without a helmet but when it comes to putting sandwiches before a dying baby and then defending such action as reasonable, Britain has sunk to a new depth."

Look at them all! Scum! Every single one of them in it for themselves....

I don't remember 'can expect to take regular abuse and beatings' as part of the job description of Paramedic, maybe I missed it. I was probably too busy stuffing my face while watching this model citizen use her public standing to earn a few extra quid prancing around on Strictly Come Dancing. Silly me! For the record Ann, yes, we do worry about our safety but that doesn't stop us doing our job. We just wear stab vests so it hurts less. I was recently at an award ceremony for my service where staff were given the Chief Ambulance Officers Commendation for bravery. There was a crew who were beaten with a fence post and still went on to treat their attacker despite numerous broken bones. A crew who continued to do CPR whilst being repeatedly stung by wasps. A crew who disarmed a man with a gun. A policeman who sat next to a burning motorbike to protect the man lying in the road. Crews who day in day out put their lives on the line and for what? For the appreciation of our wonderful politicians?! If Britain has sunk to a new depth it's because of people like you. People so deluded and out of touch, that they label the little people their servants. Ms Widdecombe is not alone. Only today Tory MP Christopher Chope refer to the House of Commons catering staff as his servants. It's YOU who is out of touch, YOU who should be defending actions and YOU who should be answering accusations of sinking Britain to new depths.

I don't recall her or any Tory writing an article about the members of the emergency services who have sustained serious, life changing injuries in the course of duty as one of their 'servants'. Then again when she has the opinion that 'the service exists for the benefit of those who staff it rather than those who need it' it's of no surprise that these articles are not forthcoming.

'The purpose of education is teaching the young, not keeping bad teachers in their jobs, the purpose of the National Health Service is to make people well, not to give doctors evenings and weekends off and the purpose of the emergency services is to protect the public, not the staff’s nosh. Elementary, Dear West Midlands Ambulance Service.'

The purpose of education is teaching the young, so stop moving the goalposts and start supporting your teachers. The purpose of the National Health Service is to make people well, so stop privatising it, cutting funds, cutting staff to line your pockets. The purpose of the emergency services is to protect the public, so stop trying to turn the public against us, stop cutting ambulance funding, stop cutting police numbers, stop reducing wages, stop taking away our pensions, stop expecting us to work for 12 hours with no breaks and stop lying. Elementary, Dear Right Honourable Ann Widdecombe.

Oh and just for the record, you of all people should know that we the ambulance services are NOT emergency services. We are essential services. School girl error there! And I thought you were an educated woman, how on earth did you land the role of questionmaster in Cleverdicks?! They certainly didn't teach you the art of investigative journalism in your time at Birmingham University or Oxford! (See what I did there? Researched! You should try it some time.) You simply cannot put an article making sweeping statements into such a public forum, full of conjecture based on inaccurate information. It is nothing short of negligent, especially from someone with your social standing.

Like Ann, I also rage against the society we have become and when I heard about Thomas Passant it was indeed upsetting and heart wrenching. As a parent I know only too well what I would be feeling in that situation but putting food before the life of a child is not what we have become, not what we have ever been nor will ever be. We will always, always always try everything in our power to help anyone who needs it whether or not we have eaten, whether or not we have had a break, whether or not we have been at work for 14 hours already and whether or not we may get hurt along the way. We certainly don't work 80 hour weeks, 12 hour shifts, long nights, take abuse, receive violence and take repeated public attacks from washed out politicians for the money! £10.12 an hour is only tolerated because it's a job we love. If I wanted money and an easy life I'd work in McDonalds or go into politics. I reckon I'd be rather good at fiddling expenses and reality TV! Maybe that's what I'll do!

Perhaps Ann Widdecombe would like to come for a 12 hour night shift on a Friday (Or Richard Madeley). Would she be happy to face her adoring public in their time of need? Would she like to explain the real cause of the delays? Would she be happy to interrupt her rest break for a 43 year old male bleeding from the wrists, holding a knife and threatening to stab the first person through the door? Come on Ann! It'll be fun! I'll bring the nosh! Or maybe you'd like to find somewhere safe and warm, paid for by your servants, and write about it instead.

'Nero fiddling while Rome burned is the image which comes to mind.' Indeed.

You Tell Me

“19 year old, assault, head injury”

There are times in your life where you just have to say ‘whatever’ and move on. Be it with family relationships, spouses, work or whilst trying to argue your point to an Indian call centre; sometimes the point comes in any uphill battle where you just give up and walk away. Today was one of those moments.

We were called to a park by the police for a guy who had been in a fight. We arrived to a sea of blue lights, lots of coppers and various chavs scattered around. As we got out the cab a couple of cops came wandering towards us with our patient. ‘Patient’ is probably too kind... specimen is more appropriate. 

He was wearing some beige chinos which were elasticated around the ankles, some navy blue Toms with no socks and the most garish of Ralph Lauren polo shirts in the most ghastly mustard yellow colour. To go with this rotten ensemble he had a huge diamond (fake) stud in each ear, a gold cross round his neck (he so isn’t religious), an Omega watch (fake) too big for his skinny wrist and various tacky sovereign rings on his fingers. To top it off he went with one of these new types of baseball caps, I think they are called ‘Lidz’ and was wearing it to one side. He walked with what looked like a limp but I am reliable informed this is called a ‘bop’, he had lines shaved into his eyebrows and when he spoke he sounded like a cartoon character with something sticky stuck in his larynx with an awful grasp of the English language. Anyhoo, he ‘bopped’ past us in his handcuffs, up the steps and into the ambulance. 

The copper told us he had been punched, hence the cut above his eye but that was all they knew. He also told us that he had a chip on his shoulder and a hatred for all uniforms.

“Good luck!”

Well, this should be fun! 

“Right, what’s happened this evening?”

“You tell me, innit”

“Well I don’t know, I just arrived, that’s why I am asking you.”

“You’re the doctor.” he said in a very cocky tone.

“No I’m not, just tell me what’s happened.”

“You tell me.”

“Have you been punched?”

“You tell me.”

“Did you lose consciousness?”

“You tell me.”

“Why won’t you answer any of my questions?”

“You tell me”

“You’re acting like a child, just answer my questions and you can leave.”

“What did you say to me bruvs? WHAT...DID...YOU...SAY?”

“I said you’re acting like a child.”

“Don’t test me bruvs, I will cut you.”

I looked up at the copper and raised an eyebrow. He laughed!

“Firstly, I’m not your ‘bruvs’, secondly, you’re not going to do anything, now just tell me what’s happened.”

“You tell me” he chuckled to himself.

“Do you want us to treat you or not?”

“You tell me BRUVS.”

“We are done here.” I said to the copper, “He’s acting like a child.”

“Don’t step to me bruvs, I’ll end you, you fucked with da wrong nigga innit (he was white), you bes watch your back, I’ll be der waiting, do you know me, do you KNOW me?”

“You tell me...”

With that, he was grabbed by the handcuffs and dragged off the ambulance, staring at me the entire time. As he reached the bottom step he spat towards me and kissed his teeth. All that did was get him bundled to the floor. What a foul little animal. 

When did our youth end up like this? Why is there such little respect for any uniform? The Nanny-state we live in has allowed this Chav culture to breed and fester. They have quickly become well regarded as the rednecks of Britain. They have far too many rights; they know the law and the police can do very little. Parents do nothing to stop it and even schools allow it to continue. There is no discipline anymore; back chatting is tolerated and every figure of authority faces a struggle to impose themselves on these thugs. It makes me so angry looking at them, listening to them and being around them. Watching the death of the English language is horrible to see and a stand needs to be made before it becomes irreversible. Can you imagine these cretins working in the media; presenting TV programs & writing articles?! 

“Yes bruvs, welcome to the News at 10. Safe.” 

Their intimidation and aggression strikes fear amongst many and their threats of violence means they mostly go unchallenged and avoided. They hang around street corners drinking and smoking; generally causing a nuisance to all that go near them. They are parasites and should be treated as such. This ‘culture’ needs stopping in its tracks. 

Now, where do we start? You tell me...

It's what we wanted, right?

"1000s of Emergency Service workers seriously hacked off"

I've read a lot recently regarding what this current government is up to and I have none my fair share of bitching about it. I have no real political allegiance, nor do I think that any of the three many parties are any better equipped than each other to change things for the better. There is too much in-fighting and political gain to be made from empty promises. I have watched with frustration whilst the Tories have made universities unaffordable for all but the elite, increased the cost of living considerably, fuel prices rocket, the housing market stagnate and the economy crumble. Our armed forces were slashed on all fronts and public services faced cuts to budgets and front line staff. All can be rationalised under the heading of necessity. Financially the country was / is in a mess. Cuts have to be made to reduce the national deficit and sure, every one felt the pinch. Then, there was the NHS bill. Now there is police privatisation. These goes way beyond reducing costs. This is about profit. This is a direct assault on what our country has held in high regard for so many years. 

I have often had inter-service banter between us and police about which is the number 1 emergency service. We have our reasons why we are and they have theirs. I was going to write a 'police vs ambulance' blog where obviously, we would come out on top! In light of recent events however it seems pretty pointless. They are two great services which do this country proud. Two services which only serve to help and protect our people. They are not and should not be about profit and the cuts that are being made to both with have huge implications. You find me a voter who wanted more crime, less police on the beat, less ambulances and costly health care. I think you'll struggle.

The LAS is the largest "free at the point of contact" emergency ambulance service in the world. We respond to over 1.5 million calls a year within the M25 and employ over 5,000 staff. We are a non profit organisation as are the other 12 NHS ambulance trusts. The government cuts have caused the loss of almost 1000 staff in London alone, most of which are front line. Private, profit making ambulance services are becoming more common place and when the reforms are pushed through, in spite of huge opposition, that will signal the end for the ambulance services that so many millions of people rely on every day. We pride ourselves on the fact that everyone gets the best treatment we can give without social standing being a factor. Sadly, rather than pulling our drug guidelines from our pockets we'll be pulling out price lists. When profit becomes the driving force behind medical care people are simply priced out of the market and have to choose between treatment or rent. But hey, that's what we wanted, right?

The story is no different with our police force. Across the 43 police authorities it is predicted there will be a loss of almost 35,000 staff, most of which will be off the front line. The government is only to fast to criticise when forces can't cope with the public unrest so obviously reducing the amount of officers is the answer. Lets not forget our police face criminals with guns and knifes with nothing more than pepper spray and a stick. They have limited resources when it comes to crowd control with little or no use of baton rounds and water canons. Despite the lack of weapons and the few officers available, we still lock up more criminals than any other European country. What more do people want from the police? The governments answer appears to be privatisation. Out-sourcing police work to untrained, muscle heavy companies like G4S who are there for money and money alone. They will be less accountable and less trust worthy. But hey, that's what we wanted, right?

I'm not saying the emergency services are beyond budget cuts. No one is. Even the Fire Brigade will have their sports equipment budget reduced but recent government actions go way beyond budget cuts. It is quite simply, systematically deconstructing the NHS and police force for personal and financial gain. Let's be honest, if we stay as we are no pockets will be lined. I don't know what stand can be made. An e-petition with over 150,000 signatures has been ignored and the coalition the the people voted into power are simply ignoring the the people who put them there. The NHS bill and the privatisation of the Police will signify and end of an era. But that's what we wanted, right? 

NO IT'S NOT! No one wanted or wants this. No one wants costly health care, no one wants a fragmented police force. No one wants less ambulances. No one wants less police offers and No one wants this inept, out of touch government failing to deliver ALL of their promises to continue this ill conceived policy agenda. I say no one because the people it doesn't effect are rich enough not to care and only stand to profit form this countries demise.

Interestingly, if you were to combine the budget cuts of the all UK ambulance services, polices forces and fire brigades in 2011 it wouldn't come close to the amount that the publicly owned Royal Bank of Scotland paid out in bonuses in the same year. Funny that. 

More Musings from Another Waiting Room

"25 year old female, waiting for an X-Ray in a waiting room"

A few months back when I started blogging I wrote one entitled 'Musings from a waiting room.....'. It was inspired by an unfortunate A & E admission by myself where I was forced to sit in waiting room for almost 6 hours with a bunch of morons. I threatened that I may take up this subject again and now due to recent events I got the chance to spend another prolonged stretch of time in one of the most depressing places one can be. Like before I sat there patiently waiting my turn watching hordes of people come and go. To be honest I was disgusted with what I was seeing. The pathetic reasons people were there, the shameless dress sense, the poor parenting, the immigration problem laid bare and just generally the lower echelons of society amalgamating in waiting room during the middle of a weekday. My opinions may make me a snob, in fact, they probably do but I don't care. I was there by appointment, I was reasonably well dressed, I sat on only one chair and sat quietly until my name was called. That is what waiting room etiquette dictates, that is what is courteous to do. Apparently the general public think otherwise. This is what the NHS is up against.

The Divas and their sprogs:           They were about 25 years old. She was a gobby diva and talked loudly like she was from the Bronx, he was a poser and sat sulking on the bench. Their twins were about 18 months old and screamed constantly. Their solution was to give them a Nintendo DS each, with the volume on full. Selfish much? Oh, when the crying started again, 3 packs of sweets were the order of the day. Not ideal for a toddler but what do I know?

The English language:          Her nor the children could speak a word of English. From the sign language to the receptionist the boy had a sore throat. They were told that they should go and see a GP. This was A & E for accidents and emergencies. They nodded and sat in the waiting room and as there was no way to communicate with them they were booked in despite it not being appropriate.

The Mobile Phone:             Like I said in my last waiting room rant, phones have a silent function. Silent should be enabled when at work, in meetings, on buses, trains and hospitals. Why? Because it's the courteous thing to do. When in a crowded public place having you phone repeatedly play Betty Everitt's Shoop Shoop song is more than a tad irritating. In fact having a conversation about the fact you're sat in a waiting room so everyone can hear is also infuriating. 


The Hot Baby:            In comes a frantic looking mother clutching her offspring tightly! I can overhear her telling the receptionist she has a temperature that won't go away with Calpol. Erm......doy! See the hot baby? Yes, the one you are holding. The one wrapped in a vest, 3 baby grows, a sleep suit, 3 blankets, a duvet, a space blanket, a sheep skin, a bobble hat and gloves. Yes, that one. That is why she still has a temperature. If you wrapped me in that I would sweat like a weight watcher in a cake shop! 

The Hypercondriac:           The was a large lady sat on the front row. She had one leg up on the seats next to her occasionally looking around the waiting room seeking apparent approval and sympathy for her injury. The funny thing was her 'severe' injury gradually improved with each stage of the triage process. When her name was called she hopped into the assessment room. She hobbled out.....! She hobbled off to xray. She limped back.....! She limped into the Doctor. She walked out........

The Drama Queen:             The generations of a family all equally as melodramatic. They were on my bench. The 9 year old had apparently broken her wrist. She clearly hadn't. After triage she wasn't put in a sling. After xray she was sent back to the waiting room yet even then the mother was on the phone to all and sundry saying how she may have a 'severe break' and may need surgery! I sense some Munchausen syndrome by proxi!

The Chav Family:         I want to vomit. The was apparent ill though you wouldn't have guess. Glammed up, peroxide hair in a council face lift, chewing gum with a mouth like a toilet. He was dressed Ali G with bum fluff, the 3 year old boy was dressed like a mini Ali G with his ear pierced and drinking a can of coke. The 5 year old girl was a mirror image of her 18 year old mum but with cornrows for a haircut. The worst behaved kids I've ever seen, running around, shouting and swearing which the parents repeatedly went outside to smoke.

The School Boy:          This insolent little punk had a constant smirk etched across his face. I never worked out what was wrong with him. His fat obnoxious parents were both there which to me meant neither of them worked. No surprise there. They also felt it appropriate to verbally abuse reception staff because they had been waiting for 2 hours. So what! So has every other prat in the place. And I told them so! When his name was called his parents were outside having a fag and he was in the toilet. I said nothing, just smiled. Poetry!

The Teenage Lesbians:             I have nothing against lesbians. Some of my best friends are lesbians. I do however have issues with unnecessary public displays of affection. And I mean full on groping, not just a kiss. You're supposed to be ill for starters, let alone being surrounded by children! The first one was a goth, with ears, eyebrow, lips, nose and cheeks pierced. She was also sporting a ridiculous haircut but hey, each to their own. The other one, the 'ill' one was obese, had achne, was wearing a 'rainbow' striped hoodie was the Hindu Aum symbol on the back. This was accompanied by pyjama bottoms and Ugg boots. This isn't and never has been a look. You are in public. Make a bloody effort or failing that, at least get dressed!

All of these people could and should have been treated by their GP by appointment but why bother? Why wait? Why not clog up a hospital? And why not make it a family outing. I mean it's like going to the zoo but instead of animals there are ill people and instead of the gift shop there is a vending machine and pharmacy giving out free medication. After an initial triage if they should have gone to the GP just say"Go away"! If it isn't suitable for A & E don't treat it. No wonder the NHS is always under pressure, these people who pay tax and don't pay national insurance abuse it with no deterrent. Set some rules for the waiting room about noise, mobile phones, attitude and having takeaways delivered and enforce them. Hospitals have security, use them! I you don't obey the rules you don't get treated. 

The Concrete Jungle

"19 year old male, ? Heroin overdose, history of violence *LOCATION MATCH"

First job of the day, it was early on a sunday morning, we were tired and a tad grouchy. As soon as the job came down our radio started ringing.

"Don't approach, police on route, the patient is violent. Hold for police"

Dur!! As if we were going to be cavalier.  Location match is a red flag. Previous crews have flagged the address as dangerous so either he has been violent or someone in the address has been violent. We would be waiting and then hiding behind lots of police officers! We arrived at the same time so grabbed our stuff and followed them up. It was in the middle of a council estate and one the countries largest. It contains almost 2000 homes and although still popular with the elderly residents, due to schemes like 'care in the community', problems came to fruition when large volumes of vulnerable and disadvantaged people became isolated from society. Concrete jungles like this are vast. This particular one has over 6000 residents and takes 20 minutes to walk from one side to another. The road network through the estate is scattered and complex making navigating for us and patrolling for police extremely difficult. In all seriousness the area is simply too large to police effectively and as such it became a breeding ground for crime, drugs and antisocial behaviour. On an estate where deprivation and violence are commonplace, hopeless life is the norm leaving children without ambition and little prospect of bucking the trend.

As a result, we end up with our patient. A 19 year old male, high on drugs, unemployed with a criminal record longer than the ancient scrolls of Jerusalem. He had no education, his mum was an alcoholic and his dad was in prison. His 3 brothers were all in the same boat as him. We entered the block via the large metal door, a small window hole showed the remnants of the glass that had once been there, bloodied tissues lied in pools of urine and tinfoil stained with crack drifted around the stairwell like autumn leaves. As we climbed the stairs, passing the masses of graffiti we could could hear the commotion. He was smashing up the flat. He was high on MDMA and Trips. He was hallucinating and being violent towards neighbours and his family. We didn't get near him. The police brought him to us already restrained. There wasn't much for us to do other than monitor him. He needed to be sedated at the hospital so for us it was a bit of a non job but it highlighted the problems we, the police, the government and the residents of council estates face.

This job was symptomatic of the problems that are common place all over the country. There are over 6 million people living on council estates in Britain and a large percentage of these people are living in properties that are rundown, isolated and abandoned. In the heart of every thriving city in Britain is a second city. A city hidden from visitors. A city hidden from public view. A city the government would like to forget. A city where more often than not, good people are kept prisoners by the fear of gang rule. And what chance do the police have? A few years ago on this estate, there were 6 officers and a sergeant dedicated to patrolling the area. Admittedly that isn't much for the size of it but dropping it to just 2 beat officers under the Tories has seen a lot of the good work undone. Despite the £12.5 billion flurry of initiative under recent governments promising the 'big society', promising community improvement, promising re-galvanisation, promising criminal justice and promising more policing the mish-mash of projects has produced very few results and have made little to no dent in the growing level of violence and drug abuse in deprived urban areas. Street violence, drug dealing, robbery and burglary have risen and the much vaunted Anti-Social-Behaviour-Orders have become a prize more than punishment.

These estates cause a huge financial burden on the tax payer in both policing costs, medical cost and benefit costs. Unemployment is high, benefit fraud is rife and crime is huge. With unemployment so high it is of little surprise that poor diets and abuse of drugs and alcohol cause a strain on ambulance trusts and local hospitals. This job alone required 12 police officers and an ambulance, let alone the hospital stay and the administration costs of sending him back to prison for breaching his bail. Then there are the costs of keeping him in prison. Multiply this un-isolated job by every estate the country over and it is painfully clear why a decade of broken promises and failed costly initiatives have put the country in a state of economic fragility. Fix housing, fix policing and fix the benefit system and you'll go some way to fix these communities. Or instead we could spend £10 billion on hosting the Olympic, allow bankers multi-million pound bonuses from tax payers profits and fund ailing countries in the Eurozone. The problems faces by communities all over the country can be summed up by one word: Poverty. Poverty of income, poverty of opportunity and poverty of expectation. Poverty is a term we use for 3rd world countries but it is a real problem that exists in our own country. A country billed as 7th richest in the world. Something isn't right is it?

Poverty in the UK

• Worst in the EU, longest working hours, lowest social spending
• By EU decency threshold the minimum wage should be £7.87. It's £4.98
• Three times more UK children fall beneath the poverty threshold than in 1970
• The base wage for the bottom tenth of the population is worse than 30 years ago (relative)

Crime in the UK

• 1% of the population suffers 59% of all violent crime
• 2% of the population suffers 41% of all property crime
• Most criminals commit crime within 1.8 miles of their home. 92% of these criminals live on council estates consumed by poverty and criminalised by war against drugs
• A lone 18 year-old woman with a child is five times more likely than average to suffer from crime

Homes in the UK

• Almost 6 million people - 10% of the population live in Britain's 2.9 million council homes
• A further 3 million live in homes that have left council control since 1988 through 'Right to buy schemes'
• Since the public sector reforms in the 70s many traditional jobs done by council tenants have been contracted to private companies making tenants less secure and worse paid. 62% earn less, 73% have fewer holidays, 53% have worse sick pay, 51% have worse pensions and 44% have less security

The longer these council estates are left to rot, the bigger the social disparity will become, the higher the crime rates will be and worse off this country as a whole will be. Lets get our own house in order before we try and fix others.

Yeah but no but...

"32 year old female, diarrhoea"

Firstly I wondered who calls an ambulance for diarrhoea especially at the healthy age of 32? Secondly, who does this on Christmas day? Surely, hospital is the last place on earth anyone would want to be? To be fair I shouldn't be surprised. Who am I to judge anyway?! We pulled up outside the rather bedraggled looking house in the rather bedraggled looking street in the rather bedraggled looking neighbourhood. A few token Christmas lights hung from windows, the street was covered in litter, bins lay on their sides and as we walked up the path we had to navigate the piles of dog mess. A dead looking Christmas wreath hung from the front door. It was a pretty miserable scene! A little kid opened the door, ran off down the hallway and disappeared into a room on the left. We followed and entered the living / dining room. It was a sight to behold! Imagine the Royle Family. No, not the Queen, Prince Phillip and the Corgis, think Ricky Tomlinson and Sue Johnston from TV series. Add to the mix an offspring of Vicky Pollard and Ali G plus a few scruffy looking children and you'll be close to seeing what I was staring at. All were wearing the obligatory paper Christmas hats, a staffordshire bull terrier was sat expectantly at the side of the table wanting some of the mangy looking turkey. Silence engulfed the room.

"Happy Christmas! Who are we hear to see?"

"Me, innit" 

That "Me, innit" came from the Vicky Pollard of the motley crew sat in front of us. She was of weird proportions, a space-hopper for a body, clad in an ill-fitting t-shirt with 'LUSH' written across it. Her bottom half was 3/4 length joggers, barely big enough to cover her festively large legs and hind. Her hair was pulled back tightly into a pony-tail, her face covered in multiple piercings, a few in the ears, nose, lips and eyebrow. It wasn't a good look. I knew the following conversation would be a struggle at best but unfortunately it was a conversation that had to happen!

"OK, what's your name my love?"

"Chantelle"

"Hi Chantelle, my name's Ella, what's been happening today?"

"So I was sat down having my Christmas dinner right and I farted yeah and it felt squidgy so I went to the toilet and I realised I had shit myself yeah and it smelt fishy so I thought I had C Diff (* see below) innit so I called 999. Is it C Diff? 'Cause I heard that is really dangerous right, I think I need to go again, shall I not flush so you can look in case it's C Diff? I'm not ill but I do need the toilet again"

And breathe! What do you say to that? There was a short pause where me and my crew mate just stared in amazement and then he saved me!

"No, we won't need to see it. Have you been unwell recently or was this the first time you've been ill"

"No, the first time was just when I farted, innit"

"Any other symptoms? Any pain? Any vomiting?"

"Nah"

Thank god he spoke because I was still staring, looking at her, her family, the house, the dog, trying not to laugh. I eventually composed myself.

"It doesn't sound like C Diff but if you....."

"Yeah but how do you know?"

"As I was saying, this was your first episode of diarrhoea, you haven't been unwell and you haven't tried any home remedies such as Imodium. You also have no abdo pain, no fever, no vomiting and you don't appear dehydrated. It seems to just be an upset stomach."

As I was talking and trying explain that all she had was diarrhoea she began to put her coat and shoes on. 

"You don't need to go to hospital, you'd probably be more comfortable to stay at home and see how it goes"

"Yeah but it smelt fishy innit so it might be C Diff"

"I doubt it's C Diff"

"Yeah but it might be right?"

I wasn't going to argue, I'd had enough, it was Christmas day and I was arguing about fishy diarrhoea. Enough was enough. Hospital it was then. Who am I to give a medical opinion? We took Chantelle to the nearest hospital, handed over to the nurse and were redirected to the empty waiting room.

"Right, just wait here until your name is called. See you later, hope you feel better"

I walked away, the automatic doors slid open, I began to step through to the cold Christmas day air when she shouted:

"When will I know if it's C Diff?"

I just kept walking!

* Definition: Clostridium difficile (or C difficile) is a bacteria that normally lives in the large intestine (colon). C difficile may cause inflammation of the colon (colitis) when it becomes too prevalent in the large intestine. This overgrowth of C difficile may take place after a person has taken antibiotics that have killed the helpful bacteria that live in the intestine.

C difficile can be passed from person to person. A person may not have symptoms of having an overgrowth of C difficile, but he may still be able to pass the bacteria on to another person.

C difficile can cause diarrhoea, abdominal pain, vomiting, dehydration and fever.

Zero tolerance? Afraid not.........

"45 year old female, obnoxious asthma sufferer"

It was about 11pm, we had been to a lovely old guy who had had a fall and popped him to the local hospital. We stood patiently in the corridor waiting to hand over to the hospital staff. About 10 ft away was a middle aged woman sitting in a hospital wheel chair. She was obese, not very well dressed, her hair was that of a wild banshee and she had a very large chip on her shoulder. From what I gathered, she had been brought in my ambulance about 20 minutes ago for an apparent asthma attack.

The reason I noticed her was the swearing and shouting.

"Oi, am I booked in? I need a fucking bed, I'm ill"

She repeatedly barked abuse at any staff who walked passed and all that did swerved around her like she was a leper. I'm assuming she was well known to staff and had previous for this behaviour.

"I need a fucking bed, I've got asthma" (pronounced ass-em-eeer)

She was pretty relentless with requests for treatment. A few staff explained that there were many other sicker patients in front of her but she didn't seems to care. To be honest she didn't look or sound like someone suffering an asthma attack so I'm not at all surprised she was sat in a chair.

"Iv'e got asthma, you have to treat me. You're supposed to give me nebuliser (pronounced Nebooo-lizer) within 15 minutes, it said so on the news. I'm iller than all these people, I need a fucking bed"

Everyone appeared more amused than annoyed up until this point but when here abusive requests were ignored she began a torrent of racial abuse at a couple of nurses. Her ignorance was quite horrible to watch. What a sorry state our society is in when people like this are unashamedly able to voice these vile opinions and selfish demands. She wasn't ill, she was simply draining resources. Security arrived to subdue her and she got seen by a doctor in the corridor. What annoys me is nothing will happen, there will be no repercussions, no punishment. She will continue to repeatedly abuse A & E, probably claiming every benefit and disability allowance under the sun. Her racist abuse won't be punished and hospital staff will continue to treat her. And why? Surely when someone abuses staff their right to treatment is relinquished. At what point will the NHS and society as a whole just say No!

No, we won't accept this.

No, we won't treat you.

No, you can't have your benefits.

No, this isn't the end of it.

Yes, you have to leave.

Yes, the police have been called.

Yes, we are pressing charges.

Yes, you are never welcome in this hospital again.

Take this hard line, 0 tolerance approach and maybe just maybe things will slowly begin to change. In reality, she'll be discharged and be back within a few days, dishing out the same abuse as she does every time and as her abuse gets her seen what incentive is there for her to stop. There are similar signs on every ambulance and in every hospital stating:

In order to ensure that all patients attending this department receive the treatment that they need, it is essential that our staff are able to work without fear of attack, abuse or harassment. This Trust views its staff as its most valuable asset and therefore any abuse to those staff is totally unacceptable. Police assistance will always be requested when violent incidents occur and the Trust will support staff that wish to bring private prosecutions against the perpetration of physical abuse. 

In reality this hard line isn't followed. Police, if they turn up, defuse the situation but rarely make arrests. If they do no charges are made once the person has sobered up. Every day staff are subjected to this abuse but no one wants to be the person who refuses treatment, just in case. Again, the fear of backlash and litigation is palpable and while that fear exists nothing will change.

Whilst all this was going on our patient waited quietly and patiently and was thankful to us and all hospital staff for the help he had received. I bed he had to wait longer for his treatment than she did though.

Gangs, Knifes and Amnesia

"19 year old male, stabbed in back"

Working in a city, we see our fair share of knife crime. It happens much more regularly than the media report. In reality you only hear about it on the news if its a teenager who has been stabbed or rich white man was stabbed by a black man. In practice, stabbings occur every single day and 99% of it is young males in gangs. The dispiriting truth about the cities gang culture is that it is not only large, with at least 100 gangs, but it attracts ever younger children. There must be worthwhile alternatives for young people to gang membership, not just limited to sports centers. Education is the most powerful force for change: government-driven improvements in schools in deprived areas will, it is hoped, offer teenagers more fundamental alternatives to the gangs, by providing them with the skills and discipline to aspire to employment and further education rather than an existence as drug-pushers.

The London riots showcased to the world the gang culture that exists and the roots of these appalling events are many and complex but none more so than the way Britain's educational establishment has cringed helplessly in the face of ever increasing gang culture; a culture that rejects every tenet of liberal society. It's violent, it's sexist, it's homophobic and it's racist. Unfortunately,  it is broadly tolerated by many people in the poorer communities, which has lost control of its teenage youths. Those youths scare the wits out of teachers and social workers, the public and police officers. Knife crime is rife and not enough is being done to stop it. There is no parity in sentencing for offenders, not enough police resources available to tackle the issue head on and not enough incentives for these young people to buck the trend. In London alone (I choose London because they are the easiest statistics to find!), there were 7,231 knife crimes in 2010/2011, a 29% increase on 2008. There sits evidence enough that the issue is not being tackled and whilst there are Conservative promises of more cuts to front line police the numbers will simply increase.

We were called to an address in rough part of town. Music was blaring, there were scores of people loitering with intent outside the address, buzz words such as 'retribution' and 'revenge' were being branded about. This was clearly gang related but for us, the problem with gang related stabbing is the clear and concise history! Our guy was stood in the living room, tempers were high, testosterone at critical levels and don't even get me started on their dress sense! He however was topless, bleeding from a rather large stab would in his back. I was concerned about the levels of air entry in his left lung and was keen to treat as I found, however, he didn't want treatment, he wanted to go out, I assume, tooled up looking to hit back at the rival gang. Nether the less, the police assured him he would be going to hospital. Now the history.

"So what exactly happened?"

"I don't know"

"What were you stabbed with?"

"I don't know"

"Who stabbed you? Was there a gang of them?"

"Can't remember"

"Did you get in a confrontation?"

"No"

"Where did this happen?"

"Cant remember"

"So you were just walking alone, realised you had been stabbed, but didn't see anyone, hear anything or feel anything?"

"Nah, I got back to yard yeah and my home boy told me I was bleeding, innit"

Wow! Amnesia is so frustrating. To loose the memory of such a memorable event must be a nightmare. How on earth will the police catch the bad guy? In a word, they won't. They will continue to chase their under-resources tails until they come across another teen. Dead. Stabbed by the guy with amnesia. And why? I can't remember!

This guy didn't die but also didn't appreciate the significance of what had happened. It was just another day. Gang life. It comes with the territory. For too long, the less affluent areas of society have been left to breed this hatred and it is now endemic. The softly softly approach clearly doesn't work, job and financial incentives are futile because more money can be eared in pushing drugs. What is needed is 0 tolerance, long prison sentences, removal of benefits, confiscation of property. What the government needs to do is give the police the powers to stop this mindless violence and criminality in its tracks but instead, they have a different solution. 16000 less officers! Genius! That'll fix the problem!


#AntiWinsorNetwork

Claim Pain

"RTC, Cars vs Car, 3 patients with neck pain"

Over the past decade, a culture of claim has slowly developed in Britain. Advert slogans like 'where there's  blame, there's a claim' encourage people to claim for absolutely anything. A woman made a claim for £1m because her chair 'farts', gamblers sue casinos for loosing money, McDonalds were sued because someone burnt their tongue on hot coffee. The growing litany of ludicrous litigation needs to end. We now live in a country where kids can't do a sack race, can't play with conkers, where every injury costs companies money and where even burglars can sue for injuries sustained while 'on the rob'.

The fear has gripped every council and business and the introduction of absurd rules, regulations, signs and labels have become common place but one of the biggest areas abused by the public is that of whiplash. England has become the whiplash capital of Europe. Over 1300 claims are made every single day and accounts for over 75% of all injury claims in the country. This huge amount of claims has in turn led to a huge amount of companies encouraging people to claim. Just type 'claim' in to any search engine and see just how many there are.

We were called to the above job. When we arrived there was a big black BMW, a man, a woman and a child occupied the seats. Behind them was a mini cooper. Standing next to the mini was a mother and child. They were both fine, and the reason they were fine, was the it was a 2mph impact. Not a mark on either car. The police who were on scene had requested the incident be reviewed on CCTV. It was and the following came of the radio:

"No more than 2mph. The front vehicle didn't even move"

Case closed? No. I had 3 patients. The eastern european family in the BMW all had neck pain. Even the 2 year old. (I couldn't confirm this as he didn't speak english but the parents assured me that despite the fact he was laughing, the child had neck pain)

"Ok sir, stay nice and still, we are going to arrange to have the roof cut off your car"

Like a jack-in-the-box he leapt out of the car, as did his wife and the child was removed. Amazing recovery. They made it clear they needed to be checked over and needed a copy of my paperwork. 

"I'll give my paperwork to the hospital"

They declined hospital. They wanted to go and see their own doctor. Totally fed up and frustrated I completed the necessary paperwork and off they went. And here lies the problem. They will put in a claim. The lovely lady who bumped them will be financially punished with an increased premium despite there being no damage OR INJURY! The family will probably be awarded £2500 each for whiplash injuries as they are hard to prove and the doctors who assess them don't care. Doctors are there for diagnosing and treating but they are being used to alleviate social conditions and perpetuate a compensation culture. If you’ve got a doctor who is being paid £200 for every report he stamps, there is no incentive for him to turn around and say ‘I don’t believe you’.

I don't know what is being done by the government but something has to give. These idiots got 2 police cars, an FRU, an Ambulance and no doubt 3 GP appointments. For emergency services alone you are looking at a net bill of £3000 to the tax payer. Multiply that by the 1300 claims a day and its evident that 'claim pain' is not sustainable. Stop it and that 'national deficit' may become easier to wipe off.