Before the reorganisation of Local Government in 1974, many services including water, police, fire services and all health services outside of hospitals which included the ambulances, were run by the bigger city councils called ‘corporations’, or in rural areas their county councils. I was privileged to serve on the Leeds Corporation’s Health Committee 1972-74.
Some while prior to that I had suffered the awful experience in another city of a man collapsing with a heart attack. I telephoned for an ambulance which arrived, but quite clearly the job of the ambulance crew then was to get the ill or injured swiftly to hospital where treatment could be given and no attempt, therefore, was made to revive the unconscious heart attack victim.
At an early meeting of the Health Committee I raised the problem of no on-the-spot revival techniques. The only qualification for ambulance crews then to do their job was a first aid certificate and a clean driving licence. It was resolved that enquiries be made about the best ambulance service in the UK which could deal with heart attacks. We were advised that the very best ambulance service was in Belfast.
I was asked to visit Belfast along with Leeds’ Chief Ambulance Officer, the Leeds Medical Officer of Health and a heart specialist consultant from the LGI.
We were booked into the very posh Europa Hotel. I was a little concerned because then, councillors were not paid. We were allowed an accommodation fee if there were overnight stays on Council business but it was only half what the Europa cost! But I put that out of my mind and concentrated on why we were in Belfast.
Subsequently in the years following, I learnt that the Europa Hotel had been bombed nine times! On the first evening, when we were out walking in the town centre, we were stopped and frisked by security forces – my male colleagues on the pavement but I was ushered into a small wooden shed. I thought how ironical it was that there was the threat of death all around us yet Belfast had the best life-saving system for heart attack recovery.
The next day we visited Belfast Royal Hospital and were shown into a ward for heart recovery. I will always remember the utter bewilderment on the face of one man who had been unconscious after his attack and had just woken up to find himself in bed in a hospital away from the life he was leading and what he was doing the day before.
We discovered the reason why Belfast was so good at saving life was that the ambulance station was situated immediately next door to the Royal Victoria Hospital. If the station received an emergency call for a heart-attack then a doctor specialising in heart disease went out with the ambulance.
In Leeds the ambulance station was in Saxton Gardens a considerable distance from both the LGI and St James’s. We started the process of investigating a radio system (obviously before the days of mobile phones) so that at least the ambulance crew could be in touch with a heart doctor. But then local government reorganisation came and the ambulance service went to the Area Health Authority and the ambulance-to-doctor radio contact scheme was abandoned.
In hindsight it is obvious that the ambulance crews should be qualified to deal with patients on the spot and stabilise their condition before removal to hospital. In the USA where the main cause of premature death was road accidents, it was the job of the police to take the accident victim to hospital as quickly as possible with their maxim of ‘scoop and scoot’! Unnecessary deaths resulted.
In the mid 60’s in Pittsburg, Pennsylvania, Austrian-born Dr Peter Shafer, Director of Anaesthology at the University of Pittsburgh School of Medicine, introduced an eight month intensive training course for emergency ambulance crews, in collaboration with the Pittsburgh United Negro Protest Committee. That Committee had founded Freedom House Enterprise to give black people jobs including running an ambulance service. Their ambulances were fitted with defibrillators and other medical equipment. They were so successful at saving lives that not only the black community but also the white community preferred to telephone Freedom House rather than the police if they had a medical emergency.
Eventually, this success was recognised by American State Governments which introduced state-run ambulances during the late 1970s. Scandalously, Pennsylvania never acknowledged what was owed to Freedom House and made it difficult to the point of being nigh on impossible for former Freedom House ambulance crews to be employed in the state-run ambulance service.
Unbeknownst to us in Leeds, Brighton Corporation, persuaded by local heart consultant Dr Douglas Chamberlain, had trained six ambulance crews to deal with heart attacks and strokes in 1971. Again, when their Area Health Authority took over, this was not pursued because the Department of Health would not recognise the benefit of training ambulance crews in resuscitation techniques. It took a medical conference in 1979 in Harrogate when eminent heart specialists spoke in favour of trained ambulance crews that the DoH relented.
Rather than visiting Belfast we should perhaps have visited Brighton but councillors can only take decisions on information presented to them.
Today, our emergency ambulance crews are highly educated in emergency recovery. It takes at least a year for a paramedic, as they are now called, to learn to do their job including residential courses. Some decide to go to university to take honours and masters degrees in emergency resuscitation and treatment before becoming employed. And, of course, like all other university students, they have to pay university fees and do not receive any income while they are students.
When the paramedics attend a patient they are able to stabilise the patient treating them for up to an hour. Sometimes their treatment is so successful that there is no need for the patient to be taken to hospital.
If hospitalisation is required, the paramedics stay with the patient in the back of the ambulance until they can be handed over to the hospital.
But we are now in a disastrous situation with ambulances queuing outside hospitals to transfer their patients. To be waiting, with patients after a long day or night shift not only is this not acceptable but also it endangers the lives of others waiting for paramedics to give emergency treatment which, at the moment, cannot be immediately available.
For too long our NHS has been funded to just get by with no slack in the system to cope if there are outbreaks of flu or other viruses. It is time that it is recognised by everyone that as we are living longer and medical treatments are more complex and invariably more expensive, that they have to be adequately funded as well as our overworked and demoralised hospital staff.
And, of course, in the meantime, ensure that all of us who qualify receive our flu and Covid jabs to, not only protect ourselves, but also help stop the spread of viruses to others. This will help to allow emergency ambulances to arrive promptly and save lives.
This post was wriiten by Hon Ald Elizabeth Nash
Photo: A Leeds City Ambulance at Saxton Gardens ©Leeds Libraries via leodis.net
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