A special relationship......

"22 year old male. Unconscious and bleeding heavily"

A weekend in the city wouldn't be the same without drink, drugs, violence, vomit, blood and blue lights. More often than not, all the above are on the first job of the night. Today was no different. We were on station but our shift hadn't started yet. In a garage that holds 8 ambulances and 8 cars, our truck sat alone & being a Sunday night there was no management around and no admin staff. It was just us doing our VDI when the phone rang. We had already spoken to control to give our fleet number and skill level so they knew we were there so we had to answer! It was a begging phone call pleading for us to start early as there was a Cat A call and no other resources to send. Obviously we obliged, so not really knowing if we were missing anything we shot out the garage. It was only 3 miles we had to travel but doing that at 18:00 on the day of a Spurs vs Arsenal match and heading to Tottenham causes bit of a tricky drive. That aside, we arrived about 15 minutes later to a sea of blue lights. In the road was a guy lying on his back surrounded by police. As I stepped out the vehicle I could see a considerable amount of blood on the WPC's hands. The closer I got, the more blood I could see on all of their hands. What a mess!

The guy had been stabbed numerous times in the leg and once in the stomach and he wasn't in good way. He was pale, sweating and very drowsy. The police were applying fantastic pressure to the wounds so I took a moment to come up with a plan whilst listening to a vague handover. No one was exactly sure of what happened but what they did know was that a large crowd of 'anti emergency service' youths was gathering and were shouting abuse at us and the police. I called for HEMS back up or an FRU. In fact I believe I actually said "send me anything". If ever there was a reply which summed up David Cameron's reign of terror on front line services this was this:

"Sorry, we a spread thin. HEMS are tied up and there is nothing else available at the moment. We've got A & E support running from 13 miles away but until then you'll have to make do. As soon as something comes up I'll send them. Sorry guys"

Still think cuts to emergency services is wise? Hmmm! I wanted someone who could assist in major trauma. No disrespect to A & E support but they are not even aloud to do an ECG or give Calpol. They would be as useful as a chocolate teapot. It was us and the police. I started cutting the guys clothes off. He was panicking but we were far to pre-occupied with his life threatening injuries to be able to talk to him. Cue the police. Not only are their 12 officers trying to keep the crowd back, trying to protect us from some missiles that were being thrown but were applying pressure to wounds, opening dressing, passing us kit and constantly re-assuring our patient. No instructions needed. They just did it. The main source of bleeding was his groin. It was an arterial bleed and was taking all of my energy to apply the pressure needed to slow it down. My crew mate was placing orange cannulas (wide bore cannulas for trauma) in both his arms and drawing up fluids. It was a real mess. 

I was aware of two things. Firstly, the crowd was becoming angrier by the minute and things were getting rather volatile between them and the officers who were now almost making a cordon around us. Secondly, our patient may well die where he lay if we didn't move soon. Again, without prompting the trolley bed appeared. The police knew we had no hands to do it our self. Normally we'd use a scoop or sheet to lift someone but with the number of bodies we had at our disposal it was just a case of lift and run. We got him on board and put in the blue call to the trauma centre. As we were about to leave an FRU turned up. He dumped his car and at our request, drove the ambulance. In the back was me and my crew mate and three cops. The three who had saved our patients life. We arrived at hospital and bundled into resus. The guy was transferred and hospital staff took over from us. Off we went to the blood bath that was our truck. There was blood everywhere, everyone was saturated but it was a good job done by all. 

This job itself would have stood up well as a blog in it's own right but for me it was a great example of the special relationship between the ambulance service and the second best emergency service; the police! (sorry guys, couldn't miss out on the banter). No matter what the job is, there is a respect and admiration between the two of us. We wave as we pass each other on the road (take note fire brigade) and there is always a welcoming look of relief when one of us arrives at the others scene. This was a perfect example of two public services working well together for one purpose. The police come under a lot of stick and put up with much more abuse and violence than we do and normally shrug it off as being part of the job but that isn't good enough. They are a fantastic bunch of people who do the toughest job in the most difficult of circumstances. This country is lucky to have such an outstanding force and the sooner that is recognised by the mindless minority the better. This guy WOULD have died, I have no doubt, if the police hadn't done what they did but it won't gain them any respect or thanks from the idiots who abuse them. It wasn't their job. It was ours but they did what they had to do. I wrote a letter of thanks to their police station, only knowing their shoulder number. I hope it got to them. That's the funny thing. There are so money different police and so many different ambulance crews, most of the time we are working along side officers we have never met yet the respect and professionalism never wavers. Time after time, we call them when there is even a hint of danger and they come running. I'll always be in their debt and as such will always be more than willing to give my call sign, even on the ninth time of asking. Bless 'em!

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.

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!


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