- PANORAMA "CASUALTIES"
17 JANUARY 2000
When this teenage girl collapsed by the poolside,
paramedics were called to her aid.
There wasn't any urgency. There wasn't any contact
between the paramedics.
Her parents thought she'd be in safe hands, but the
paramedics were out of their depth. When this woman
was attacked, this paramedic did nothing.
Negligence. How can we ever live with that?
Just how good are Britain's paramedics?
[Scenes from Casualty]
In real life as on the TV drama Casualty, Paramedics
are the shock troops of the health service. Eleven
years ago we were promised a paramedic on every
ambulance. But the reality doesn't always match
At the very least paramedics don't improve your
chances of survival in serious trauma.
Some of those who've seen them in action are losing
I'd be really, really worried if I had to call out a
paramedic. I really would
CHIEF EXECUTIVE STAFF AMBULANCE TRUST
Anybody suggesting doing it differently is seen as an
SENIOR VICE-PRESIDENT AMBULANCE SERVICE ASSOC.
I think it's been one huge success story, the
development of the ambulance service in this country.
Away from the world of TV drama, that trust is
sometimes misplaced. Tonight Panorama reveals that
shortcomings in the ambulance service and its
paramedics' lack of training are costing thousands of
lives each year. At the same time, huge regional
differences between the treatments paramedics give
mean your chances of surviving a heart attack or a
car crash may well depend on where you live.
MRS JANICE TURNBULL
The girls were very close, they did lots of things
together. Although there was a ten year age
difference, Katy loved to go off shopping with Hailey
and she loved having Hailey friends around.
Hailey Turnbull and her baby sister Kate lived in
Durham. At fifteen, Hailey seemed fit and healthy.
But her life was about to hang on the skills of two
Anything to do with the water she loved it. She
actually started swimming lessons at a very early
age. She was very confident in the water.
On 2nd March, 1995, Hailey went to a life-saving
class. But she was about to face her own emergency -
for real. Her parents lived just minutes away. They
were phoned by the baths and told Hailey had
collapsed. They rushed to be with her. Mrs Turnbull
was stopped from going to her daughter, but her
husband was let through. He found himself confronted
by a horrifying sight. Hailey was on the poolside,
unconscious, being given mouth-to-mouth resuscitation
by the lifesaving instructor. There were also two
paramedics who weren't treating Hailey at all but
carrying in equipment.
MR MALCOLM TURNBULL
I hadn't been there very long when I didn't feel
things were right. The only person at the time
treating Hailey was the poolside trainer. I think the
first reaction Janice was to come out and say to you,
Hailey's dying in there and they're not doing
anything about it. There wasn't any urgency, there
wasn't any contact between the paramedics. It
appeared they were just carrying equipment.
Their own official report reveals the paramedics
thought Hailey was having an asthma attack - although
her parents had told them she had no history of
asthma. In fact, she had suffered a cardiac arrest -
quite why, we still don't know. Every second counted.
She needed immediate electric shocks from a
defibrillator. Her life was ebbing away. It took
eight minutes for the paramedics to arrive. Another
eight minutes went by before they used their monitor
and saw her heart had stopped.
Hailey was starting to go blue, her lips were going
blue, and I said to one of the ambulance people, she
needs oxygen, she needs air, she's not breathing.
First they wasted time trying to pass a tube into her
lungs to give her oxygen. They'd carried two
defibrillators to the poolside - but now they decided
it would be too dangerous to use them, because of the
I had the impression that we'd phoned 999, that the
paramedics were there, they were the cavalry, they
were the people who would come and save Hailey's
life. I expected them to take over. But the longer
time went on, that just didn't happen.
They moved Hailey to the foyer. There was no water
there but they still didn't shock her heart. It
wasn't until they reached the ambulance that they
used a defibrillator - at least 24 minutes after the
999 call. It didn't work. Doctors finally restarted
her heart in hospital. But it was too late. Deprived
for so long of oxygen, her brain had been fatally
damaged. As a later inquiry confirmed, the paramedics
had first misdiagnosed her; then failed to give her
the treatment she needed.
If they'd assessed the, the situation immediately and
moved Hayley to the ambulance, hopefully that would
have happened much, much quicker and, you know,
consultants have told us that, that would have given
Hayley a much, much improved chance of survival. And
it was probably on the Sunday that they withdrew the
sedation and said that she was actually brain dead at
Malcolm Turnbull cannot but dwell on the mistakes
that were made, and wonder whether his daughter might
There isn't a day goes by than I think of Hayley and
I think 'what if..'. What if I'd put her in the car
and taken her to hospital? What if the paramedics had
been better trained, better qualified? Would Hayley
still have been here? And that's a question I
continue to ask myself.
Hailey's death was investigated by the Health Service
Ombudsman, who was highly critical. But the
paramedics kept their jobs. The local ambulance
service said it had learned valuable lessons and
changed its clinical practice.
If the paramedics who treated Hailey Turnbull had
been better trained, perhaps they might have realised
what was wrong with her more quickly, and so saved
her life. Here in Bristol, where the BBC series
Casualty is filmed, I asked people what they knew
about paramedics, and how much training they thought
QUESTION: What do you know about paramedics?
I've seen them on Casualty, they're highly trained,
they have motorbikes and ambulances, and, God forbid,
if I have an accident, they'll save my life.
QUESTION: How much training do you imagine paramedics
actually get in real life?
Hopefully, an extra two years?
I would imagine it's similar to doctors: several
years' training to actually do it.
A couple of years? Nearly as much.. not as much as
like a doctor, but about as much as like a nurse or
Three years at least.
The reality is rather surprising. After a year on the
road as a technician - basically a driver qualified
in first aid - the trainee paramedic gets just six
weeks in the classroom, followed by a few week's
experience in hospital.
QUESTION: What's your reaction?
I'd be shocked. And if I ever do have a road
accident, I hope there's someone more trained than a
paramedic. I'm surprised.
Yes, I would have thought it was a lot more than
that, considering what they have to do out and about.
They haven't got any other back up of the hospital
staff or anything like that when they're out there,
they're on their own aren't they.
Gosh! They're so important. That's incredible.
Professor Jon Nicholl heads one of the country's
leading medical research teams, the author of several
reports on ambulance care. Some of his findings make
PROFESSOR JON NICHOLL
MEDICAL CARE RESEARCH UNIT, SHEFFIELD UNIVERSITY
I think the public probably think that paramedics are
better trained than nurses. Whereas the opposite is
true. Most paramedics only get four to eight weeks of
theoretical training, followed by a similar period of
practical training, followed by a year on the road
when they're working as paramedics but they are
trainees still. Nurses. on the other hand. usually do
a three year course which is a mixture of practical
and classroom training. But it does go on for three
years, so this is really quite a different degree of
Is there anybody else in the health service who has
to make a life or death decision about what to do
with a patient who's only got four weeks training in
PROFESSOR JON NICHOLL
Well nowhere else in the health service I think would
And the consequence of the fact that it does happen
must be that some people die who otherwise might
PROFESSOR JON NICHOLL
Yes, I'm sure that that is a consequence, the only
thing is that we know that it is surprisingly rare.
The Ambulance Service Association, which represents
the service nationally, insists there's no real
problem. But it accepts there's room for improvement.
SENIOR VICE PRESIDENT AMBULANCE SERVICE ASSOC.
Paramedic training today is very robust and provides
an infinite improvement in care over the last decade.
What we are saying is that there is growing evidence
to suggest that the role of the paramedic can be
So you do accept the evidence that things aren't
quite as good as they might be?
I say there is limited evidence to suggest that we
can improve things, and that's natural.
Another doctor who has researched the state of
pre-hospital medicine is Charles Deakin. He is also
disturbed by what he's found, and is convinced that
paramedics need more training.
DR CHARLES DEAKIN
SOUTHAMPTON GENERAL HOSPITAL
Generally it's been assumed that the standard of care
that's being delivered in the pre-hospital
environment has been adequate and that casualties are
delivered to the hospital with everything possible
having been done for them. Over the last ten years
though there has been quite a lot of research that
has brought this into question. I think in terms of
what we're asking them to deal with and the severity
of injuries then a significantly longer training,
certainly more than the six to eight weeks that they
have already, would be appropriate for paramedics who
are being asked to deal with seriously injured
patients on the road side. It would certainly improve
their diagnostic skills and the skills in terms of
treatment that they offer.
In this exercise at the national fire brigade
training centre, a paramedic with many years
experience directs the other emergency services. In
reality, things don't always go so smoothly. The
first thing a paramedic has to do is ensure the
patient can breathe properly, that their airway is
clear - vital to prevent brain damage. Research
suggests that paramedics aren't as good at this
fundamental part of their job as they should be. More
than half of those taken to hospital with serious
injuries arrive with some airway obstruction.
DR CHARLES DEAKIN
These results have been quite surprising really,
everyone has assumed that airway management has been
optimal on the roadside.
People are now beginning to look at whether the
airway skills that paramedics are taught are
Sometimes, the only way to help both heart attack and
accident victims breathe is to put a plastic tube
down their windpipe. Anaesthetists also do this in
hospital when they give a general anaesthetic. It's
DR CHARLES DEAKIN
This is the view you see as you look into the back of
the mouth to insert the tube into the trachea, the
windpipe, and then you can see the soft pink tissue
beneath that which is the epiglottis which covers the
windpipe, and then underneath that are the vocal
cords and it's that structure through which we try
and pass the endotracheal tube. Unfortunately, with
trauma patients, often the view is not as good as
So it's actually more difficult because of the angle
of the head, often, to intubate by the roadside than
it is in hospital?
DR CHARLES DEAKIN
Doing it on the roadside is a lot more difficult.
Anaesthetists aren't allowed to intubate patients
until they've done it at least a hundred times under
supervision. Paramedics, on the other hand, will go
out on the road after just twenty practice attempts.
You ask who can deliver an intubation in an upturned
car at night, then it's the paramedic who can and
it's the anaesthetist who can't. The training really
does show that the paramedics are capable of doing
that, and they perform the intubations day in and day
out very successfully.
But what you're telling me is that paramedics are
just better at intubating patients than
In the pre hospital setting.
DR CHARLES DEAKIN
That's an interesting view. I would be surprised that
if someone who had done twenty intubations, whether
they were an anaesthetist or a paramedic, was better
than someone who was doing it every day of their
An NHS study in 1998 found that more than a third of
intubations attempted by paramedics failed. Yet in
Britain, only doctors, not paramedics, are trained to
intubate a group of patients who often need it most -
people with head injuries who aren't completely
unconscious. Trying to insert a tube will make them
choke and vomit; yet without intubation, they will
suffer brain damage.
DR CHARLES DEAKIN
The only patients, in terms of trauma, that they can
intubate successfully really are those with what we
call a Glasgow Coma Scale of 3, that's patients who
are completely unresponsive and patients who are
completely unresponsive from trauma have a very, very
poor outcome, probably less than 2 or 3 percent
survive. The only trauma patients that paramedics can
intubate are generally those that are dead.
The only way to intubate semiconscious patients is to
give them anaesthetics and muscle relaxing drugs to
dampen their gag reflex. In America, where most
paramedics are trained for two years, they can give
these drugs. Giving their British counterparts these
skills might have dramatic results.
DR CHARLES DEAKIN
If you can intubate patients on the roadside with a
head injury then you make a big difference in terms
of whether they survive or not. You're probably
looking at somewhere in the region of 600 to 1,000
patients who could have survived.
If a paramedic fails to diagnose an injured patient
correctly, the consequences can be fatal.
My mother was very good with children and if somebody
was ill she'd go round and see them.
Janet Delaney was a healthy woman of 58. She lived in
Derby with her daughter, Kelly, not far from her son
Patrick and his family. On 9th July last year she
popped out to collect her wages from the local pub
where she worked.
I was speaking to my mum about different things, and
she seemed okay, she seemed fine. She seemed happy.
And then I went upstairs to have a bath because I had
arranged to go out that night with a friend.
While Mrs Delaney went out, a few streets away,
Nicole Beresford was getting her children ready for
bed. She knew Mrs Delaney by sight.
I came downstairs and I noticed there was a bit of
commotion in the street, so I went outside to have a
look because I thought somebody had knocked my cat
over, and then realised it was Mrs Delaney lying in
the road and she looked like she'd fallen backwards,
or someone had dragged her backwards. To begin with
we all felt that she'd been mugged or she'd been
attacked or some such sort because she always carries
a black bag with her and she'd got no black bag with
her, and the contents of perhaps what would have been
in her bag were all sort of thrown all around her
Nicole noticed what looked like blood on the back of
Mrs Delaney's head. She appeared to be unconscious,
and began to vomit. A passing driver dialled 999.
First on the scene was a paramedic in a rapid
response car, Brenda Blood. The Ambulance Service
thought highly of her, and had chosen her to appear
in this TV documentary about the job of a paramedic.
She saw Mrs Delaney and her response was "Oh
she's drunk, she's not a very nice person, I know her
and she's drunk" and we were all quite shocked
because she hadn't made any examination. All she kept
repeating was "No, she's drunk" and then
the paramedic put some surgical gloves on and got
onto the floor and slapped Mrs Delaney across the
face a couple of times to ask her to get up.
Mrs Delaney lay in the street for half an hour until
an ambulance arrived. Brenda Blood told them to go
away. In fact, Mrs Delaney was sober: she'd drunk
only a pint of lager hours earlier. But the paramedic
called the police and asked them to deal with her.
How long in all was the paramedic in the road with
Mrs Delaney before she was finally taken away?
It was well over an hour before the police arrived
and took her, well over an hour.
And in that hour did, at any stage, the paramedic
examine Mrs Delaney?
No, not once. The only time the paramedic went near
Mrs Delaney was to remove her teeth and slap her face
and that was it.
Brenda Blood told the police that Mrs Delaney was
drunk, and they took her home. Her daughter was there
to meet her.
My mum got out the police car and she seemed really
confused, she didn't know where she was, she was
disorientated. She seemed really strange. And the
policeman said that she'd had a few too many.
Assuming she needed to sleep it off, Kelly left her
mother on the sofa and went out. Mrs Delaney had
arranged to meet a friend that evening. When she
failed to turn up, he went to her house and let
himself in. He saw at once she was in a critical
condition, and called another ambulance - which did
take her to hospital.
Did you see her in hospital?
I got there two minutes after she'd died.
Mrs Delaney died from a fractured skull. Two men have
been charged with her murder. The Ambulance Service
refused to comment to Panorama, saying the case is
sub judice. A few weeks after Mrs Delaney's death,
ambulance officials agreed to talk to her family,
only to cancel the meeting an hour before it was due
to start. Brenda Blood, the paramedic, has been
suspended, pending a disciplinary hearing.
She's gone through that attack, and then the people
that have come to save her treat her and call her a
drunk. Slander and negligence - how can we ever live
A recent study by Professor Nicholl assessed whether
being treated by paramedics improved patients'
chances of surviving serious injury. The conclusions
The findings in that report were that there was a
higher mortality amongst patients treated, patients
with serious injuries treated by paramedics, than
similar patients managed by non-paramedics.
He assembled a panel of experts, who looked at 179
cases where paramedics treated people who had died
from injuries. They tried to assess whether these
deaths were avoidable.
They thought that seventeen of these patients, who
were attended by paramedics, could possibly.. their
lives possibly could have been saved. But when they
looked in detail and thought about everything that
had been done, they finally concluded that eight of
them had probably avoidable deaths.
So one in ten might possibly have lived; almost one
in twenty probably could have done. Professor Nicholl
says similar numbers die avoidably in hospital too.
But the Ambulance Service Association seems
Trauma cases themselves represent less than 10% of
the demand that is placed upon emergency ambulance
services. The incidences are tragic, they are
certainly regrettable, but it important that we learn
from them. But then to suggest that those few
isolated incidents undermine the quality of the
training delivered in this country, I think is
perhaps an insult to the service.
Across the UK there are 36 ambulance services. Each
has its own treatment instructions laid down by
committees of doctors known as clinical protocols.
We've carried out a survey of some of these
protocols, and found wide discrepancies. This is No
Man's Heath, where four counties and three ambulance
services meet - East Midlands, Staffordshire and
Warwickshire. If you find yourself here, dying from
heart failure and someone dials 999, you'd better
hope the ambulance comes from Warwickshire. Their
paramedics, and theirs alone, can give you a shot of
a life-saving heart drug, frusemide, and also the
best drug available for relieving your pain,
diamorphine. On the other hand, if you were lying in
a smashed up car with a punctured lung, your best
hope would be an ambulance from Staffordshire, where
all paramedics learn a life-saving technique to keep
you breathing, needle decompression. And East
Midlands? Well, most of their paramedics couldn't
give you any of these treatments. But then again, the
chances of the ambulance coming from East Midlands
are fairly small. There response times are much
slower. Some of the biggest differences between
services concern drugs. One example is Warwickshire.
OK, these are some of the drugs that we carry that
other ambulance services don't, we've got Frusemide
for relief of patients suffering from left
Now what's that?
It's a drug, it helps remove some of the fluids when
people have... they've got bubbling on the lungs and
it basically it gets the whole system on the move
I mean is that really a life saving drug?
It can be a life saving drug, yes, certainly. When
people go a long way down the road they're almost
drowning by the time we get there.
Last year Warwickshire paramedics gave Frusemide to
140 patients. Yet our survey reveals only five
ambulance trusts give this drug across the country.
When Derbyshire, Leicestershire and Nottinghamshire
merged to form East Midlands last April, one of them,
Nottinghamshire, had been using the drug. But after
the merger, it wasn't extended to the other areas,
while in Nottinghamshire it was actually restricted.
Here's a drug, you use it in part of your service
area, not in the rest of it. It seems absolutely
CHIEF EXECUTIVE, EAST MIDLANDS AMBULANCE SERVICE
But at the end of the day I have to be responsible
and accountable for what happens out on the road, and
I'm accountable for the drugs and the authorisation
at the end of the day.
But you can give that authorisation in
Nottinghamshire. You're saying you can't in
Derbyshire or Leicester. It makes no sense.
I can't give that authorisation.
Well your committee and your and...
The authorisation comes from the medical committee
that I've been talking about.
But where's the logic? They've authorised it for use
in Nottinghamshire. It doesn't take a lot of training
to train paramedics to use this drug, perhaps a day
at best. It's not in use in Derbyshire or
Leicestershire. Where's the logic?
I'm sorry. That's.. I'm not going any further with
Treatments available for trauma patients are just as
uneven. Here on Casualty, paramedics save a patient
with a punctured lung by relieving the pressure in
his chest, a procedure known as needle decompression.
In reality, only half the 36 ambulance services can
DR CHARLES DEAKIN
If I was trapped in a car crash with a collapsed
lung, then I wouldn't want it to be in a county where
the paramedics weren't trained in that procedure.
It's a life-saving procedure and if it wasn't
performed then the outcome may well be death.
The Ambulance Service Association says it exists to
promote best practice of the kind seen on Casualty.
It doesn't always succeed.
Currently it's variable and I think it's that
variability that has been a strength, but also that
strength has got to make sure that everybody has
advantage to best practice.
And at the moment they don't.
No, some services don't use certain skills, use
Use best practice.
They don't use best practice at the moment.
This isn't the only area where the ASA is failing to
improve national standards. This is Roger Thayne,
chief executive of the Staffordshire service.
Thayne's carried out radical reforms. By focusing on
times and places of peak demand, he's cut response
times and saved money which he's invested in extra
training. It's made him unpopular.
CHIEF EXECUTIVE, STAFFORDSHIRE AMBULANCE SERVICE
I've felt like the public enemy No 1 of the ASA at
The government has set a target for all ambulance
services. By March next year, they must get to 75 per
cent of emergencies within eight minutes. So far,
only Staffordshire has met this target. None of the
others come close. In Staffordshire, Thayne and his
other managers don't just drive their desks: they
drive ambulances when necessary. Others don't seem
ready for this change.
I think a lot of them are very reluctant to change
and are in a time warp of "Well we've always
done it this way and we haven't seen it done any
differently" and anybody suggesting doing it
differently is seen as an immense threat.
Instead of waiting in stations far from where
emergencies occur, Staffordshire crews use 'forward
posts,' rooms for crews to wait in rented on housing
estates or petrol stations where and when they're
likely to be most needed. The resulting faster
response has saved hundreds of lives, especially of
patients in cardiac arrest.
Well I think it's best if you've got a bit of chest
pain to go and get it checked out properly,
especially if you have had a heart attack in the last
four weeks. It's always best to get it looked at.
In 1992 Staffordshire's cardiac arrest survival rate
was no more than the national average - 2% of
patients were resuscitated and taken alive to
hospital. Now that figure is 11%.
Just going to lift you up on to the ambulance now
If the ambulance service in the whole of England
managed to achieve that level of improvement, how
many lives might be saved a year?
Approximately 7,000 more people would arrive with a
chance of survival at hospital.
Of those 7,000 - people who are now dying - up to a
half could expect to walk out of hospital within a
week. Thayne's figures are backed by the academics.
PROFESSOR JON NICHOLL
Staffordshire are, are top of the table, they're the
sort of the Manchester United, but we're still
hopeful that if the ambulance services can move
there, which Staffordshire have already achieved,
then over the whole country, as you say, several
thousand lives will be saved, and that really will be
Have you've taken some tablets? How many?
Thayne has managed to impress the Department of
Health, which has now commissioned Professor Nichol
to conduct a study of how Staffordshire achieves its
results, and how they may be more widely applied. The
ASA is less impressed.
What aspect of best practice happens in Staffordshire
that is not happening in whole or in part in any
other service? Could you like to identify which ones?
He's met the 2001 response target for the last 4
years. No other ambulance service has yet done so.
He's reported that, yes.
His figures have been audited independently haven't
By certain people, yes.
Well they've been independently audited, you can't.
say they've been fiddled, surely?
Yes, well what I am saying.. no, there are good
No president of the ASA has ever visited.
Now you're the Vice President of the ASA, have you
been to Staffordshire and had a look at what they're
I'm certainly aware.. fully aware of what..
Have you been there?
No, I certainly haven't.
They're just up the road aren't they, about 30 miles
Very much so.
I think that they consider me very egoistic,
dogmatic, dangerous, provocative.
If I said to you that others in the ASA have
described Roger Thayne as something of a maverick,
and if I made the comment he seems to be slightly
isolated in the ASA, do you think that would be fair?
That could well be a view that's held by a number of
colleagues. It's a view of the individuals within the
association, not the association's view itself.
When paramedics make mistakes, bereaved families -
like that of Maurice Webster, a pensioner from
Leicester - feel they're much less accountable than
other health professionals.
He only lived and worked to take his children on
holiday, and then his grandchildren came along and he
just lived for them.
Mr Webster's love of life and energy concealed the
fact that by the autumn of 1998, he'd had three heart
attacks. He'd been told to go to hospital immediately
if he experienced any symptoms suggesting a
recurrence. His daughter, Lynne Harper, was with him
on the evening of 28 October. She was soon worried
about his health. He had pains in his chest and arms,
shortness of breath and was covered in a cold sweat.
An angina pill made no difference. A trained
first-aider, she feared the worst, and called an
ambulance. It arrived within ten minutes.
So when the ambulance arrived at his door, how did
you feel as you saw the crew arrive?
Relieved, that I'd got my Dad in safe hands.
Two ambulance men, a technician and paramedic Ian
Wiltshire, went in. They failed to assess or treat Mr
First of all, one of the paramedics sat straight down
into the armchair, without speaking and sat back
slumped in the armchair watching the television, and
there he stayed. Sat there tapping his cheek,
wiggling his feet.
For almost 40 minutes, paramedic Wiltshire did
nothing. Meanwhile, Mr Webster's condition was
deteriorating. Lynne's daughter, Jayne Milankovic
arrived. Eventually, Jayne says, as if spurred by
boredom, the paramedic examined Mr Webster.
When they did finally put the equipment on him, blood
pressure, ECG, they started to give each other
alarming looks. He stopped watching TV - the one in
the chair. He looked at his colleague. His colleague
looked back. They still didn't speak. They still
didn't say a word to each other, and within seconds,
he'd stood up. "Right we'll get you to hospital.
Straight to hospital."
His family never saw him alive again. Mr Webster died
soon after reaching hospital. His family feel his
death was avoidable.
We could have got him in the car ourselves. Got him
to hospital far more quicker than they had. We could
have actually walked to a bus stop, got him on a bus,
and got him the treatment quicker.
And if you had, he might still be alive?
He may well be.
Not long after the funeral they were sent an
anonymous letter from a group of ambulance staff
which confirmed their suspicions.
We received a fax from our solicitor, on Ambulance
headed notepaper, stating their disgust at the crew
that night. How they felt that this crew was letting
the Ambulance Service down.
Lynne and Jayne made a complaint, asking questions
about the paramedic's failure to treat Mr Webster.
There was a disciplinary hearing but the family
weren't told its outcome. They knew that the
paramedic had kept his job.
I can't tell you what disciplinary action was taken
against the crew. I have a responsibility of
confidentiality as far as the crew is concerned, as I
have a responsibility for confidentiality as far as
patients are concerned. Disciplinary action has been
taken against that paramedic, and
that paramedic has been subject to considerable
Drinking while on duty. Stealing from your employer.
They're all dismissible offences, but there's no
clarification on what they can do or not do to the
public for fear of losing their job. It just seems
that they can get away with so much.
That, however, is set to change. Last year,
Parliament agreed to make paramedics a state
registered profession, like nurses. Under the new
register, they could be struck off for professional
misconduct. But this is at least eighteen months from
coming into force. The new register will be run by a
board under the Council for Professions Supplementary
to Medicine. Its registrar says that for six months
the Department of Health did nothing to set the
register up, failing even to agree the names for the
board. At the end of last year they began to act.
What do you think suddenly made events start to move
I believe it could well have been this programme
They would have felt embarrassed if there hadn't been
the names after such long delay knowing that we were
about to broadcast to Panorama.
I don't know, but certainly the name of this
programme was mentioned when contact was made between
the NHSE and ourselves.
And in what context, what did they say?
Asking when the board was to be formed, and were told
why the board could not be formed, because we'd not
got approval of the two names we needed for council
from the paramedics.
So, the DoH contacted you and said, Panorama's coming
out with a programme about paramedics, why is there
no board, and you had to point out that they had to
make the next move?
That is correct.
The new board will have other powers, for example, it
could insist on better training. For bereaved
families like the Turnbulls whose younger daughter
Katie now attends the lifesaving class like Hailey
did, the need seems clear.
I think we have to look very closely at what we're
asking paramedics to do. We're asking them to take
over from doctors. We're asking them to make
decisions that doctors make. Yet we only give them
six weeks training.
I think its very unfair to put that much pressure on
The ASA also accepts there's a need for reform. As an
interim step, it wants to introduce a slightly longer
training syllabus of the kind already used here in
Staffordshire. And looking further ahead it wants to
create a new grade of superparamedic with degrees.
The problem is, unlike doctors or nurses, whose
training is funded centrally, ambulance services have
to pay for training their staff. No one knows where
the extra money for these improvements may come from.
If that's the objectives of the ambulance service in
the United Kingdom, then we need to ensure that we
set up the financial framework in which to ensure
that training takes place.
So what you're saying is you have an emerging concept
for improving ambulance training but you don't know
who is going to pay for it.
Quite right. There's a lot of questions still to be
Meanwhile, lives that might be saved are being lost.
What we could do is make sure Hailey didn't die in
vain, that we can learn from her death, that we can
get a better ambulance service and maybe someone else
won't have to go through what we've had to go
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