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Panorama ‘Casualties’ – Update

On 31st January 2000, Terrence Carter, a Paramedic with Kent Ambulance NHS Trust, wrote to the Director General of the BBC following the recent Panorama programme. With his agreement, a copy of the BBC’s reply is outlined below:

BBC Ref: 2456217
14 February 2000

Dear Mr Carter

Thank you for your letter and enclosure of 31 January 2000 to the Director General. As I am sure you will appreciate Mr Dyke receives many more letters than he can deal with personally, so once they have been read they are forwarded by his office to this department for reply.

I am sorry to hear you were angered by the recent edition of Panorama entitled Casualties which you felt was one-sided and sensationalist. The journalist David Rose, who compiled this report, has asked me to assure you that he, together with the whole production team, fully recognise that most paramedics are very dedicated people. We know they have to put up with conditions and pay that many would find quite unacceptable and they often experience abuse or worse from those they are trying to save.

It was not our intention to criticise the ambulance staff themselves, but to examine the system in which they are forced to work. The fact is that many lifesaving drugs are available in some parts of the service but not in other, and the system is set up in such a way that the minimum requirements fall seriously below the standards of paramedic education elsewhere. Even the Ambulance Service Association (ASA) vice president Barry Johns told Panorama that many services do not deliver bast practice.

The programme began by explaining the claim that the shortcomings of the ambulance service and of paramedic training cost thousands of lives each year. It backed this claim by looking into cases where lives may have been lost for a number of reasons, namely lack of training in general (and in the skills needed to intubate semi-conscious patients in particular), the failure of some services to provide treatments which are available elsewhere, and in the failure of the ASA to acknowledge Staffordshire’s dramatic achievements in response times in order that their higher cardiac survival rate could be emulated elsewhere.

Within a few hours of the programme being shown, the production office were sent details of several more, equally disturbing case in addition to the three we featured, and they were already aware of two or three other incidents. One of the problems of UK ambulance care is that there is no effective clinical audit of what happens. As the programme showed, academic research backs the proposition the pre-hospital care is not as good as it might be, despite that fact that the paramedics themselves undoubtedly work very hard within the system in which they are operating.

Panorama certainly did not intend to undermine the ambulance staff themselves, nor did the programme overlook the tremendous work paramedics do on a daily basis. Our report concluded by suggesting there were several reasons for the problems within the system. Two of the most important were the failure of fund training centrally and the sluggishness of ambulance management, and we were hoping to use this as a starting point for debate. I can only apologise if this was not the impression you received from the programme.

You may be interested to know that the BBC’s Programme Complaints Unit, whose remit is to investigate complaints impartially and to recommend appropriate redress, are looking into this particular programme. They are independent from the programme-makers and their findings are published in a quarterly bulletin and summarised by the Board of Governors in the BBC Annual Report. I hope you will be reassured that your complaint has been taken seriously and this programme will be examined at the very highest level of the BBC.

Thank you for taking the trouble to contact us.

Yours sincerely

Lee Rogers
Editorial & Investigation Team
BBC Information