September 30, 2008

Despite Criticism, 999 Service is Far From Stretcher Case

By Lyndsay Moss

NOBODY can deny that the Scottish Ambulance Service (SAS) has had a tough year.

It has found itself at the centre of political debate in the Scottish Parliament, with alternating opposition parties using it as a stick with which to beat the SNP.

The service has faced repeated criticism over one-person crews in ambulances usually meant to be staffed by two people.

There have also been the usual - and often justified - complaints from patients and their families about ambulances taking too long to arrive.

As if this were not enough, Kevin Doran, the service's chief executive, and Grace Kennedy, its operations director, took voluntary leave from their posts in May, amid an investigation into alleged bullying and harassment.

Given all this, it would be a fair assumption that the public and other interested parties would welcome the opportunity to air their views, ask the service what they are doing to make improvements and possibly just have a rant.

Or maybe not.

At last week's annual review of the SAS, chaired by Nicola Sturgeon, the health secretary, anyone who made the trip to Heriot- Watt University in Edinburgh could have stood up and said whatever they liked, at least until wrestled to the floor by security guards.

So it was perhaps surprising that, first of all, the event was pretty sparsely attended and, secondly, that the points raised at the end of the review were in praise of the service or, at worst, neutral.

One audience member called for the skills of paramedics to have increased recognition.

"I would like to say that the part of the health service that has done better than anywhere else is the ambulance service," he said.

Another expressed concern about the safety of ambulance crews, who face violence and abuse on the job.

There was even a call to do something about the "idiots" who go walking in the mountains only to find themselves in trouble and need the service of a costly air ambulance to help them.

"They don't even have a raincoat," the concerned member of the public said.

While we may not be able to ban the T-shirt and sandal-wearers from Scotland's highest peaks, there is certainly a case for greater recognition of the work of all those in the ambulance service. This should stretch from the call-handlers dealing with stressful situations on the phone to the paramedics and technicians on the front line.

How would you like to spend your weekends scraping drunks off the pavements, knowing that just a few streets away, an elderly woman at home alone could be in desperate need of your help more urgently?

I certainly would not have the patience for this, but for ambulance crews, each call-out is about dealing with someone whose health is at risk - drunk or sober.

On top of this is the target of reaching all life-threatening call-outs in eight minutes - tough enough in the congested streets of our cities, but even harder in some of the most remote and rural parts of the country.

And, as last week's meeting heard, the service faces even more demands on its resources, including the rising cost of fuel and an ever-growing number of calls.

The SAS itself would be first to admit there are areas where improvements can be - and are being - made.

Extra money from the Scottish Government is being used to end single-crewing. Technology is helping to make sure crews get to jobs as quickly as possible. They are even going to increase the use of air ambulances to get patients to hospital quicker and free up land vehicles for other emergencies.

The ambulance service is often at the sharp end of major medical emergencies. It is right that complaints about poor performance are dealt with properly and that people's concerns are heard.

Maybe next year, everyone with good things to say about their experience of the ambulance service should head along to the annual review to help balance out the more negative reports from the previous year.

I guess the organisers will just have to make sure they book Murrayfield Stadium.

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