A hospital has admitted clamping ambulances for parking infringements and charging £50 for their release.
Security staff at King's College Hospital, south London, are clamping the non-emergency ambulances for spending too long in drop-off bays.

These ambulances are privately run ambulances who took up the contracts for patient transport. This is something that the LAS used to do in London, but then with the sneaking privatisation of the NHS the private companies started to do things cheaper and so the LAS lost a lot of these contracts.

They have, as far as I know, no exemptions to where they can park (unlike us proper emergency ambulances).

I'm not quite sure how "They clamp ambulances parked for more than an hour "to allow other vehicles into the area," works though, surely if they are clamped then they are still blocking the area?

I don't know, I'm an ambulance driver, not an ambulance parker. And if you've ever seen me park, that much is pretty obvious.

A woman has said she was left in agony when an ambulance took three hours to respond to a 999 call after a fall.
A spokesperson for East Midlands Ambulance Service (EMAS) said: "We don't have sufficient time to look into the detail to respond to this."
"EMAS is a 24/7 service. We answer 500,000 emergency calls per annum and that's our priority."

(My emphasis)

Wow...

I never thought I'd hear an ambulance service say this. I guess that the person on the other end of the phone to the reporter was having a really bad day.

I wonder if this means I can get away with telling a patient that, "I don't have time to deal with your cut finger".

(My back of a fag packet numbers for London is that we have over 1.2 million calls a year, I'm sure the official figures are out there someone but I can't be bothered to look them up. I'm working in a few hours and yes, I know we have more ambulances than EMAS).

Ambulance 'loses way' to hospital
Ambulance drivers are to get additional training after a vehicle got lost as it was taking a woman to hospital, who later died.In a statement East Midlands Ambulance Service (EMAS) said: "During the journey... the ambulance satellite navigation system failed and the driver, who usually operates in the Skegness area, took a wrong turn.
"This was realised and the crew member in the rear of the vehicle, who was familiar with the area, was able to direct the driver back on course.

I rely on the Sat-nav system on my ambulance - not so much if I'm working in my area, but if I'm elsewhere in London then I'm like a fish out of water.

Strange hospitals are the worst as I keep circling the area trying to find the A&E department.

If I do a transfer to a hospital outside of East London, there is then a big chance that I'll get another job in the area. I don't have 'the knowledge' so end up following the sat-nav or relying on one of our mapbooks.

This is a tragedy, but despite this it is a bit of a non-story in my opinion, someone from outside of the area took a wrong turn, it was corrected and they found the hospital. That the father of the patient reached the hospital 15 minutes earlier isn't unusual - I'm often beaten to hospital by relatives 'following' in the car, partly because we do various things before we leave the scene and partly because I don't drive like a loon with a patient in the back. Ambulances have different handling to cars and so we'll often drive slower.

If someone could tell me how 'better trained' can be implemented in order to make sure that when driving in an unusual area with a failed navigation system the driver never takes a wrong turn I'm sure every service in the country would be grateful.

And yes, I've taken a wrong turn or two myself and had to rely on the experience and knowledge of my partner to help me out, and I've done the same for people who have worked with me. It's why a good ambulance crew is a team.

And not being able to find a place can be one of the worse things that happens to you - as this example from the archives shows.

I got a job, '14 month child, floppy and lifeless'.
The address was given as 'Flat 1, Rose house, Starling road'.
I sped up and down the road. I spotted some of the names of the flats in tiny writing, on little blue plaques many of them pointing away from the road. My pulse started to rise. It had taken me four minutes to reach the area, but how much longer would it take me to locate the potentially very sick child?
I found 'Lilac House', 'Lily House' and 'Tulip House', but I couldn't find 'Rose House'.
Now I was starting to panic.

Something said by someone wiser than me* on Twitter today was 'Funny how the term 'socialized medicine' moves the base line. US is the exception, we have healthcare, they have have privatized healthcare'

Then I see this terrible story.

City hospital officials said they were shocked by surveillance footage showing a woman falling from her chair, writhing on the floor and dying as workers failed to help for more than an hour.

...The suit was especially critical of the hospital's emergency ward, saying it is so poorly staffed that patients are often marooned there for days while they wait to be evaluated.

While I may well moan about the state of the NHS, I still think that it was a brilliant idea and that it still does a fine job under difficult circumstances.

I think that this story should be printed on the wall of every A&E department in the country in order to point it out to patients who complain about waiting four hours for their sore knee problems.

*I've been in the same room as him twice, yet never had the chance to go and talk to him. Third time is the charm.

Dear Lord Darzi,

You are saying that the experiences of patients will affect the funding of NHS Trusts, does this include the experiences of the patient who has to wait four hours in A&E before being told that they don't deal with verrucas there? Will it include the patients who turn waiting rooms into boxing rings, or who call ambulances for a cheap taxi ride home?
If I go to a patient and they want me to carry them downstairs for their cut finger, putting my spine at risk - will I have to do it in order to keep the 'patient satisfaction' high?

And if we don't do this, either due to good sense, or because we have already stretched our current resources to the limit, then you will cut our money.

What about those patients who don't like their GP because their GP isn't 'English'?

Such people exist, and in greater numbers than you might expect. But then the view is a bit limited from that ivory tower of yours.

It is really quite simple - the expectations of the public are rising faster and higher than can be reasonably met. They want everything and they want it now, but are not willing to pay for it. They do not understand that there is rationing in the NHS, but then the government has been unwilling to mention this.

And why stop at 'dashboards' inside hospitals showing their 'quality', why not have a scrolling marquee around the outside of the hospital, it would be just as tacky.

Giving patients choice is a fine idea in principle, but for many of the patients that I deal with they just don't have the knowledge to make an informed choice on their treatment.

-Tom Reynolds
Just another ambulance man.

UPDATE: I'm not the only person to think this way.

I often joke with parents that their children enjoy scaring them.

When they are a few weeks old, they hold their breath and go blue.
When they are a year old they get high temperatures and have febrile convulsions.
When they are two years old they fall over and cut their head.
When they are seven they fall and break a bone.
When they are fourteen they either get pregnant, or make someone pregnant.

One of our commonest calls for children is the 'traditional', two year old who has fallen over and cut their head on a wall/radiator/stone/passing dog. The mother is often panicking because 'it's a lot of blood!' (even though it isn't) and we pop them down the hospital for patching up.

Sometimes a child will fall over and get a bump on the head. I take them to hospital because it's an easy job and they get to sit there for a few hours before being sent home by the A&E doctor. Simple.

Sometimes however the parents just want the child 'checked out', they don't want to wait at the hospital so they will call an ambulance and not go to hospital.

Occasionally the ambulance crew will feel kind to the parents and child and suggest that they don't need to go to hospital.

I don't know what scenario played out in this story, but unfortunately the child died. Now the father is aiming to sue the service.

I have no details of this job, or what happened - but I can talk in generalities.

If, on examining a child, they are happy, alert and interested in what is going on around them and there is no history of a loss of consciousness, then they are almost certainly going to be fine. If you take them to hospital they will be sent home most likely without an x-ray or CT scan.

I can imagine that in this instance, even if the ambulance crew had taken the child to hospital the outcome would have been the same. Only the headline would be 'Hospital in probe over boy's death'. I don't think that the child would have been examined differently by a hospital doctor than by the ambulance crew.

There is a saying among those of us at the bottom of the medical hierarchy - 'always leave another medical professional between you and the patient', or 'don't be the last medical professional to see the patient alive'. If I take a patient to the hospital, then it's the hospital's fault if something goes wrong. If the patient wants to stay at home, then I'l try and arrange the GP - so if something goes wrong it's the GP's fault.

It's medical arse covering at it's worst.

In part it's due to the media - in this story above, do you imagine that the BBC would print a story following the investigation where the ambulance staff are found to be without fault? I doubt it.

We ambulance folk are being subtly encouraged to leave people at home, and most of us are blatantly ignoring this hinting for the exact reason above. We don't want to be the last people to see a patient alive.

If I go to a patient with a sore toe I'll still take them to hospital - because if they die of an unconnected heart attack, I'll be the one to blame.

And soon, with the 'front end' model, solo responders will be expected to leave patients at home, somewhere in the vicinity of 60% of patients should be left at home, or have 'alternate pathways' for care.

I can't see many ambulance people being happy doing that.

The plan that was supposed to happen for the next two weeks is that I wander around the UK (on your recommendations), unfortunately for the last two days I have been suffering from a bout of diarrhoea and being stuck on a motorway with while desperate to visit the loo is a thought that doesn't fill me with joy.

So I'm postponing it until I feel better. The good news is that it isn't happening while I am supposed to be working, otherwise I would be up before the 'competency hearing' that I've been threatened with. That or rustling while I walk around in incontinence pads...

Good news though as I have a piece I wrote for the Guardian up at Comment is Free. Getting some interesting comments as well, which is lovely.

UPDATE: It would seem that whoever posted the article edited the final paragraph for reasons unknown. It should read

Due to public concern and the opinions of experts the government is seeking to reduce the amount of alcohol drunk, especially by the young. However until we have a change in culture of a similar magnitude to that which made 'drinking until you fall down vomiting' popular these problems will only get worse.

Perhaps in the future the fashion may be to drink sensibly.

I live in hope.