A little while ago I posted about a rumour that the LAS would have their budget cut by £25 million come a new government.

After I wrote that Andrew Boff (Conservative member of the London Assembly) got in contact with me and did some asking around in his part of the world.

This is his reply,

I've chased this up with the Conservative Front bench and they have no plans relating to any change in LAS services at all. Andrew Lansley has set out a commitment to cut by a third the cost of administration in the NHS, but equally he's made it clear that front-line services will be protected and hasn't gone into any detail about particular Trusts.

I think that coming up to an election there will be barrage of claims and rumours but I'm fairly confident that this one is probably made up though I don't know who by.

Does this mean that there isn't going to be a cut in our budget? Well, to be honest I'm not sure - but I think that Mr. Boff is genuine in believing so.

Whatever happens he's earned some kudos points from me, even if he is *shudder* Conservative, for paying attention to a lowly blogger like myself.

Now, if only I could get whoever is the minister in charge of ambulance services, and their counterpart in social care to pay attention...

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I may be clearing out some browser tabs and emails today. This may mean more posts than normal.

I wake up at 1:30 am, it's my 38th birthday and I'm awake because shift work has killed my bodyclock. Various parts of my body ache, consequences of a job where heavy, unsafe lifting is sadly a fact of life.

I stare at the ceiling, thoughts running through my head, becoming more and more hate filled as I reflect on my job.

I know that this is in part the trifecta of SAD, nightshifts and a couple of months without a 'decent' job. If I could just do a call where I actually helped someone by using medical skills my mood might improve.

I lay in bed thinking about alcoholics, drunks and wimps - about how personal responsibility seems to have become an incredibly rare thing.

I'm hating myself for doing a job where the health detriments are so pronounced while serving so many people who selfishly think that the A&E and ambulance service are there just for their benefit.

I think on the last few night shifts - of the drunks that we went to. Of people who drink and drink and drink, then 'collapse' in the street - knowing that some idiot like me will come and pick them up before they get too cold (it's only pensioners and hillwalkers who die of hypothermia these days), I'll then take them to hospital where they will continue to be mollycoddled by demoralised nursing staff.

And if you aren't mollycodled enough - well, you can always complain and get someone disciplined or fired.

The government tries to prevent heavy drinking by warning people of the effects on the liver, that they might make a fool of themselves. But people don't care, that is all so very far away. After all, isn't a hangover the sign of a 'good night out'? A badge of pride to be worn in order to prove that you are 'social' and 'popular'?

I like this advert.

But I don't think that it goes far enough.

What I think we need is something that is much more immediate, something much more telling and something that acts as a deterrent to others.

It'll need an act of parliament, but Labour seem to like introducing reams of new legislation.

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My suggestion is this - in order to teach people that the effects of alcohol on both themselves and on society are damaging and far-reaching heavy consumers need to be taught a lesson.

When called to a drunk in the street, the ambulance crew should be allowed to beat the 'patient' up, to give them the fight of their lives, to fill them in, to give them a good shoeing and to knock seven shades of shit out of them.

This will have several effects - primarily it will act as a deterrent to people who get drunk and expect public taxes to be spent looking after them, secondly it will reduce the cachet of sporting a hangover the next day in work, thirdly it will ensure that the 'patient' actually needs the services of an A&E department, fourthly it will allow A&E staff to practice their minor (and not so minor if the ambulance crew gets carried away) injury treatments on a semi comatose patient and finally it'll help de-stress ambulance crews when they find themselves going to the umpteenth drunk of the night.

I suspect that once a person has had their nose broken a few times they may eventually get the idea that drinking in moderation is perhaps a good idea.

(Also the ambulance crew should be allowed to perform 'ABC' on the patient - taking their Access, Barclaycard and Cash. This will have the happy side effect of raising ambulance wages, and thereby raising staff morale.)

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I am not mad.

But I would suspect that in countries where the police are... less 'customer focussed' there is much less public drunkenness.

Perhaps a less extreme measure would be to have the ability for A&E departments to issue fixed penalty fines if the only reason that you are in the hospital is because you were drunk and incapable. I wish the police would do this, but they are fully aware that in the great scheme of things their time is better spent elsewhere, or if not ''better spent', then tied up dealing with Kylee and Jason's domestic dispute over the bottle of White Lightning.

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I suspect that over the next few days I'll be highlighting exactly how wasted my time at work has been - essentially being little more than a taxi driver, and worse than that a taxi driver that can't refuse a punter.

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EDIT: It would seem that some people haven't recognised that this post is largely hyperbole, maybe I should have made it more explicit by suggesting that I 'kill a few - just as an example for the others'? Needless to say I don't actually think that we should go around beating up drunks, but I do think that we should introduce fines for these drunkards who abuse the NHS.

We have a lovely new ambulance at West Ham station. They are quite nice actually, there is much more leg room so it means I don't think I'm stuck in an economy airplane for twelve hours.

They have groovy new electronic systems that talk to you and do things like turn off the lights in order to save battery power - it only sometimes turns off the lights when you really need them.

It has the new electric trolley-beds, which I'm yet to encounter a problem with, although I'm sure that it's only a matter of time before the batteries that drive them start to fail. Maybe I'm being cynical.

The biggest problem is that the engine is incredibly underpowered. There is no acceleration to it at all, and it's that acceleration which you need when you are coming to a stop every five yards as you weave your way through the London traffic.

Sadly it's not there, and it sometimes feels like you need to get out and give it a push.

I blame the LAS management wanting to save money, and the environment - after all they do try to have us out driving around aimlessly, just in case a call comes down the line in the area in which they have deployed us.

(Sorry I'm being cynical, what actually happens is that the psychic computer tells us where the next heart attack is going to happen and so we are dynamically deployed depending on this crystal ball).

This new vehicle has done 2,500 miles. There isn't a mark or a dent on it.

Yet, in the last 41 days, it has needed to be taken off the road to be fixed 22 times.

We tallied it up while we were working on it last night - the picture opposite is the reasons why it has needed to be fixed.

I'm sure that, had we bought this from a shop, we'd be covered under the 'not fit for purpose' legislation and we could get our money back.

Sadly, we work in the world of NHS contracts, and I'm just not that smart to realise why we aren't sending these vehicles back to Mercedes and asking them to get them to do the thing that we have bought them for.

There is obviously a fault somewhere that needs serious fixing.

Here is a picture of the front of the ambulance repair reporting book, where we write down the faults so that the fitters can mend them. It is supposed to be left on the vehicle at all times.

Sadly, the LAS typo monster has struck again and it is down to crews to correct things.

This monster is getting more and more prevalent, the latest big memo - laminated cards sent to every member of staff in the area, told us about the policy for dealing with patients who need to go to a 'heart attach' centre.

I think it's because they have promoted one of my old officers who couldn't spell, and laminated everything.

I think he's doing something like 'business development'.

And, like all writing on the internet where someone comments on grammar or spelling, I'm sure that there is an error on this page.

My excuse (for many things) is that I'm working night shifts - it's all I can do to manage to get into work in the first place...

I've given up on the NaNoWriMo for this year - too many twelve hour shifts (I'm starting nightshifts today), coupled with some deadlines approaching and I'd have to spend twelve hour shifts when not at work writing to keep up with the schedule.

This doesn't mean I'm abandoning it, I'm going to keep writing it, and I may throw the 'beta version' up somewhere else - be sure I'll let you know when and if I do.

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Back to writing about ambulance work, work that often seems stranger than fiction.

The job I'm writing about today would, if shown as a 'Casualty' episode, have me groaning at the screen at how unlikely the events were.

We were sent to a 'male, collapsed', on the screen was the patient's name - it was a name I was somewhat familiar with.

It was a name I used to go by (sometimes I feel like Old Ben Kenobi remembering his time as Obi wan Kenobi with the amount of names I had...).

I've mentioned my father once on this site - in 2005 I wrote this,

The short version of my history with my father is that he left home when I was around fourteen (my brother was around twelve), and married another woman (without divorcing my mother first – an oversight on his part, he is after-all barely literate). Since then I haven’t seen or heard from him, which was a bit strange as the split between mum and him wasn’t acrimonious.

So my attitude toward him has basically been ‘Fuck him’, it appears that he wanted us out of his life as quickly as possible, and he has succeeded admirably on that point.

So…why was I thinking about how I’d love to meet with him, tell him how excellent my life is? I’d love to let him know that my brother is an excellent teacher and is getting well paid for his work. I’d love him to see how his walking out on us only freed both my brother and I to go on to do things that we love doing. I’d love to show him how relaxed and chilled out my mother is now. I’d love someone to read this blog out to him, so that he could know that I’m doing better without him in my life.

Actually…I wonder if he is still alive?

So – for one moment after not thinking about him for years, I’d love to rub his nose in how good my family and I have it now he isn’t on the scene.

And now I find myself going to someone who could well be him...

We arrived on scene, I was driving and I'd been telling my crewmate about my history with my father. It looked like the place where I'd last seen him more than twenty years ago, but I wasn't sure.

Then we entered the flats and from the tickle in my memory it was obvious that this was where he lived.

He was laying on the floor with one of our FRU people already looking after him. The FRU looked at us and started to give us a handover.

'This is *Firstname* *Secondname*', he said.

'I know', I replied, 'it's my dad.'

'Hey, your son is here', the FRU said.

'He probably wouldn't recognise me', I said back as my father turned to look at me.

The job itself was fairly simple, carry him downstairs, into the lift - then, after running some tests, off to hospital.

I wheeled him into the lift, it was small so his 'wife' walked down the stairs - me, my crewmate and my dad, alone in the lift.

He looked up at me and said the only two words he would say to me during the time we spent together that night.

'Say nothing'.

Now, if I had even the slightest care about him, those two words would rip out my soul and stamp on it. It would break my heart. That his son, who he hasn't seen for twenty or more years is here, saving his life and all he wants is for me to say nothing to him.

He has his new life, and he wants nothing to do with me, or my brother.

'Fuck him' would indeed seem to be the right attitude to have had over him, and I'm very glad that I've not worried, fretted or even given a moments consideration to the man that walked out on me and my brother. Now I knew why we'd never had even a birthday card from him.

He had obviously wanted to wash his hands of us.

So I switched to 'full on professional' mode. I spoke to his 'wife' (who seems quite a nice person actually) to get his history and I drove him to hospital.

After dropping him off I asked my crewmate if she thought it would be a good idea if I walked in to him, told him how well our family is doing without him and then walked out.

She rightly pointed out that despite wanting to give him a slap when he'd said 'say nothing' to me, it would do no good.

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So we left him at hospital - I don't know if he lived or died. To be honest I don't care - I care less than I would were he one of the strangers I pick up normally.

I told my mum about it, and she was furious - I think she would have quite liked to have turned up at the hospital herself, but I assured her that once my shift was over I'd stopped thinking about him.

So yes, stranger than Casualty - although I'm sure that Casualty would have had us reconciling...

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Oh, that 'other project' I mentioned? It's my new group website. And it's open.

A short break from the NaNoWriMo posts so that I can tell you about two rumours that I've heard. Note that these are rumours, if I had the time/energy/inclination I'd check them out to see if they are true, instead I'm just relying on the trust I have in the person who told me them.

If anyone knows if these rumours are untrue, feel free to let me know.*

Rumour number one is that a man from the Department of Health visited the ambulance service recently and told people that the moment the government changes (i.e Britain has a collective brain fart and a memory wipe of the last tory government and votes in the Conservatives) the London Ambulance Budget will be cut by £25 million.

This despite hitting our (stupid and clinically irrelevant) targets, despite ever increasing calls and despite the suspected pigocalypse of everyone calling an ambulance when they thing they have swine 'flu.

Additionally, somewhere out there in 'I could find it if I had the energy to Google it-land', is the government plan that a certain percentage of A&E ambulance work should be done by private ambulance firms paid for out of our budget and you can see that we will be going for the cheapest bid, which is never a good sign of quality.

Oh, and I nearly forgot - we have the Olympics coming up soonish.

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The second rumour is to do with a bit of our kit changing. This rumour however has been repeated by several people, including officers. The rumour is that because too many are going missing we will be doing away with our electronic blood sugar machines which are quick, accurate and easy to use in any circumstance. Instead we will be going back to the old chemical dipsticks that you have to wait two minutes for the result, and the result is a range of values that you read by comparing the colour of the stick to a chart.

Which doesn't work all that well, I think, considering half the time we are working in 'less than optimal' lighting conditions.

Also the dipsticks are also apparently far cheaper. And much less accurate.

Instead money is being spent on filter masks to protect me** from a milder, less fatal 'flu than is normally present at this time of the year.

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So, less money, less effective equipment and more calls. Probably less training due to the lack of money (training is normally the first thing to be cut). I can see us going back to being men with vans and bandages. Except of course that someone in government wants us to do the GP role on the cheap, but without the training is that really safe?

Expect deaths.

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To be honest I'm getting past caring. The few improvements that we've had in the service have constantly been overshadowed by new policies and ways of working that seem to exist only to destroy morale and chase unscientific government targets. We are being expected to do more for a frozen pay and with equipment that is falling apart.***

Why should I care any more? I can't do anything to change anything. Instead I should just turn up to work, pick up people who think that they are sick and take them to hospital. Then come home and watch some TV and forget about the feverish children that I couldn't record a temperature on because we didn't have a working thermometer.

Why should I get angry over it when I can't change it?

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*LAS management don't talk to me, they mostly ignore me, so I don't expect any confirmation/denial. Here is a challenge to my management - deny that either of these rumours are going to happen - here and in public. I'd ask you myself, but the organisational chart is so complex I don't know who'd I'd need to talk to.

**Sadly not only is my face such a strange shape that I can't get a mask to properly secure, but in attempting to get it fitted I managed to break my glasses.

*** An example - We drove the newest ambulance in the fleet, around 1,500 miles on the clock. We had to take it off the road twice in two days for various faults and, looking at the logbook, these were not new problems. Thank you Mercedes.