Sometimes I wish I believed that prayer worked.

Five members of the Belgian branch of Medecins sans Frontieres have been kidnapped in Sudan's Darfur region.
An MSF official told AFP news agency three international staff and two local employees were kidnapped on Wednesday in north Darfur.
The kidnappings come after Sudan ordered the expulsion of 13 aid groups, including MSF, earlier this month.
They were told to leave after President Omar al-Bashir was indicted by the International Criminal Court.

I've an interview with a MSF worker sitting on my computer waiting to be turned into text, they are good people with pure motives and I hope that these five are released safely.

The government is compiling a database to track and store the domestic travel records of millions of Britons.

Computerised records of all 250 million journeys made by individuals within the UK each year will be kept for up to 10 years.

The government says the database is essential in the fight against crime, illegal immigration and terrorism.

But opposition MPs and privacy campaigners fear it is a significant step towards a surveillance society.

The intelligence centre will store names, addresses, telephone numbers, car licence plate numbers, train tickets, hitchhiking signs and credit card details of travellers.

Shadow home secretary Chris Grayling said: "The government seems to be building databases to track more and more of our lives.

"The justification is always about security or personal protection. But the truth is that we have a government that just can't be trusted over these highly sensitive issues. We must not allow ourselves to become a Big Brother society."

Liberal Democrat home affairs spokesman Chris Huhne said: "This is another example of an intrusive database without any public debate about safeguards on its use.

"We are sleepwalking into a surveillance state and should remember that George Orwell's 1984 was a warning, not a blueprint."

A spokesman for campaign group NO2ID said: "When your travel plans, who you are travelling with, where you are going to and when are being recorded you have to ask yourself just how free is this country?"

The 'Nightwatch' scheme covers cars, flights, ferries, bicycle, taxi, ambulance and rail journeys and the Home Office says similar schemes run in other countries including North and South Korea, China, Iraq, Cuba and the historical Nazi Germany.

Minister of State for borders and immigration Phil Woolas said the government was determined to ensure the UK's homeland remained one of the most watched in the world.

"Our hi-tech electronic travel system will allow us to count and record all movements of UK citizens and [it] targets everyone," he said.
Answering concerns about the security of the database he went on to say, "The government has learnt from previous mistakes and we can categorically state that there will be no new data losses. Nor will there be any abuse of the RIPA rules to allow local councils to spy on their citizens".

He concluded, "If you have nothing to hide then you have nothing to fear citizen. Beware the terrorist and the illegal immigrant for they spread heresy".

The original, and just as scary, article is Here. If you look at the number of people that the actual scheme has caught it's 0.0036% of all travellers scanned. Is that cost effective when it comes to (a) money and (b) the damage to civil liberties?

So, apparently it snowed a bit in England, and in some places it is still snowing.

And so we find ourselves watching the TV with indignant sounding news presenters asking those in power 'Why wasn't something done!'. Sadly none of those being interviewed gave the answer I would have, "How much extra tax would you like to pay so that this one in twenty years event has no impact on your life?"
We aren't Russia, or Denmark or any of those cold countries, and the cost to fully prepare for aberrant weather conditions like this would be too high.

But.

It did seem that the London Ambulance Service was a bit unprepared. Did you know that we don't have anything to go on the wheels of an ambulance to stop it slipping in the snow? We have some covers for the officer's cars, but nothing for the vehicles that actually take you to hospital. To be fair, I'm not sure if this is economics, or down to a technical issue that they aren't able to be fitted by staff themselves.

The other problem that I heard over the radio was that some hospitals have ramps leading to their A&E department, and that the ambulances weren't able to climb them - so at least one 'blue call' had to bypass one hospital and head to one further away, one that had a ground floor entrance.

If you look closely at the ambulance on the right, you can see that it's a bit damaged. What you won't see is the damage caused to my ambulance by some idiot driving into it (and I'll tell you that story tomorrow).

Locally at least, we do have more blankets than we had this time last year, so it's not all bad.

The snow did seem to have taken LAS management by surprise though - there was only one Duty Station Officer covering the entire East side of London. Given that we were the third ambulance to have an accident, and that an officer should deal with each of those I would suggest that the next time severe weather is predicted the resourcing of officers might need to be improved a bit.

It was also about midnight when 'Gold Control', the people who normally worry about how much of our ORCON targets we are hitting decided to suspend the rest break policy. The message that was sent down the vehicle computer terminal seemed to suggest that forced overtime would be compulsory.

I doubt that that was the case, but it's definitely what it read like.

As NeeNaw says,

"I’m watching the TV before my nightshift tonight. They keep saying “the ambulance service is under severe pressure and will only respond to life threatening calls”. Surely we should only be responding to life threatening calls anyway?"

Which is sweet, but I suspect that, were I working tonight, I'd still be going to the usual twaddle of runny noses and one instance of vomiting.

I came across this heartening story while browsing the BBC News site.

A mother from Bristol resuscitated her baby boy four times when he stopped breathing - with the help of a 999 operator on the phone.
Driving instructor Cordelia Nolan, 25, said she was "petrified" when her 10-week premature baby, Emrys, lost his colour and turned blue.
Ms Nolan started resuscitation straight away and a cousin dialled 999 and relayed the operator's instructions.

I'm glad that the baby is doing well. If the baby had stopped breathing then the mother did exactly the right thing.

-----

I can usually count on a few 'Baby not breathing' calls each week the number of calls that I've actually been to when a child hasn't been breathing can, thankfully, be counted on the fingers of one hand*.

Often the 'child not breathing' is actually a child having a febrile fit, by the time we get there the fit has normally stopped and the child is either asleep or crying. It's scary but incredibly common, when an infection is spreading through my area it seems that the only calls I go to are for febrile children. I sometimes joke to parents that the only children that I see are either fitting or vomiting.

During a febrile fit a child can get blue lips, if a child holds their breath they can get blue lips - blue lips tend, on their own, to be 'not terribly worrying' on the scale of things us ambulance types worry about.

Rather obviously a child who has blue lips is a scary prospect for a parent and so they, quite rightly, call for an ambulance. Sometimes they say that the child has stopped breathing, after all that's why lips go blue.

When we arrive the child has normally made a full recovery from it's breath holding, but as we are not doctors we recommend that the child comes in to hospital with us.

What is less common, but a bit funnier is when you have a drunk who has seen his friend 'die' and managed to 'save' him with a bit of CPR. Or as we like to call it 'waking him up by pushing on his chest'. A tip - if he's pink and trying to push you off he's probably not dead**.

*After an accident with a threshing machine.

**Except when you are doing really good CPR on a dead person and they open their eyes and look at you - it's only happened twice with me and it freaked me out both times - especially as neither of them survived.

"Let's do great things."

-Warren Ellis

He's right.

For some time I think I've been coasting on this blog, much as I've been coasting in my life. The blog has degenerated into 'watch me have a nervous breakdown' while I write about the same old things. Likewise, while I have started hating my job and while feeling generally burnt out I've been doing very little to change this.

The credit crunch is a good excuse not to look for work, as is the lethargy brought on by working rotating shifts. Writing about the same old thing has worked out fine for me so far so why should I change it?

Before the Christmas break I applied for a different post within the LAS, that of 'Web communication officer', a role that I consider myself uniquely qualified for. Unfortunately I wasn't successful in getting it. I am not going to speculate on the reasons why I didn't get the post, but in any case 'on paper' I shouldn't have even been given the interview that I was granted.

As part of the preparation for trying for an internal promotion I've been keeping my blogging 'safe'. I've not been writing about the plummeting staff morale and some of the reasons behind it, about how our adherence to government targets has had a negative impact on patient care or how some of our ambulances have been dangerous to use.

Keeping these things quiet has been causing me no end of internal turmoil. When writing this blog I've always tried to be as honest and open as possible, yet I found myself sitting on stories that really should be made public. For the sake of my career I've been toeing the company line. It's been costing me sleep at night as the things that I should be writing about rattle through my head.

Well, no more.

Realising that I'm going to be stuck at my current level for as long as I work for the ambulance service has freed me to become honest again. While I will still write about the jobs that I go to and congratulate the ambulance service for the things that we do well, I will now also be writing about the things that we do poorly.

But it's not enough for me to just write about the things that directly impact me, I'm going to start digging for information. Using information gathered under the Freedom of Information act as well as talking to other people within the service I hope to bring the truth, warts and all, to this blog.

I'm going to try thinking like a journalist.

There will be some longer pieces by myself that will be properly researched and actually drafted and edited (unlike how I normally write which is 'first draft goes up after I run it through a spellchecker'). I will also be working on preparing a 'safety net' to enable me to keep paying my rent should I be disciplined by LAS management.

My goal? To have questions asked in the house of parliament, to try and change things for the better for as many people as possible and to change my own life for the better.

The other thing that I've been guilty of is that of letting things happen to me - Most of the good, interesting and fun things that I've done related to blogging have not been initiated by me, instead someone or some group has approached me with a request. What I need to do is be more proactive in seeking out opportunities and maybe creating some good things for myself and other people. To do this I'm planning some new projects and will be looking for collaborators to help me out with some of these.

As always the only resource that I have to spend will be my time and energy - something that I have in short supply. I plan to get around this by reorganising the way I run my life, streamlining things like the amount of RSS feeds I read and cutting down on playing World of Warcraft*.

So - I'm returning to this blog with new direction and hopefully some more vigour, reworking some projects that I've left fallow and hopefully joining up with some people to create new and interesting 'stuff'.

Let's see if I can do 'Great Things'.

*I've only managed to increase the level of my Warcraft character by four in the last two months which shows my flagging level of commitment to it...

David Nicholson (Chief Executive NHS)

"The ambulance service is not close to breaking point. It's tough, there is pressure on them, but I think they are responding fantastically well. Staff are absolutely responding to provide a fantastic service to our patients"

Peter Bradley (Chief of the London Ambulance Service)

"The increase that has come this winter has been far more dramatic than normal. It has been the most difficult ten days I have seen in the last ten years. It is absolutely horrendous. Hospitals are full and A&E departments are struggling. We have got ambulances having to wait longer to offload patients and that is causing difficulties."

Who do you think has the better idea of the state of the ambulance service at the moment? I know who my money is on and it's not on Nicholson.

On Monday the London ambulance service went to REAP 4. The REAP system runs from REAP 1 (no problems with the service) to REAP 5 (the sort of problems you get after all the power stations blow up and there are plague rats running on the streets of London).

We have never been at REAP 4, and if you ask the road crews in London they would probably say that we should have been at REAP 4 a couple of months ago.

From the official London Ambulance website

"Ambulance staff responded to 20,939 emergency incidents across the capital in the seven days up to last Sunday (14 December) – an increase of nearly eight per cent on the average of the previous four weeks. The pressure has been compounded by high percentages of calls initially treated as being Category A (immediately life threatening), and delays caused to staff at hospitals while waiting to hand over patients.
As a result of these ongoing issues, the Service today raised the declared pressure level at which it is operating from ‘severe pressure’ to ‘critical’ – the first time that it has reached this level since the capacity levels were introduced in late 2005."

The national news has been full of this story and there has been constant coverage that the 999 service is to be used for only 'genuine' emergencies...

...and obviously it has worked because five out of my nine calls today were to simple chest infections that could have been treated at home, seen a GP, or just sit and wait for it to go on it's own. None of them were sick enough to need an ambulance - but they called and we responded. I suspect it will be a similar story tomorrow.

We also had two hoax calls.

But I'm preaching to the choir.

It doesn't help that we had an outbreak of Norovirus at one of our local nursing homes, something that has led to a local hospital opening an isolation ward in order to safely cope with the influx. I'll tell you the full story of that night in a later posting.

Today, like many others of late, there were multiple calls being held waiting for ambulances - some of these calls would have been covered were it not for people picking up a phone and using the same number you dial if someone has dropped dead in front of you for their case of a 'nasty cough for the past three days'.

There are too many patients, 80% of whom don't require an ambulance, and not enough ambulances.

What doesn't help is that the politicians are ignoring the problem and trying to pretend that it hasn't all gone to the dogs. The politicians are being dishonest (yet again) and so, it would seem, are the executives of the NHS. Rather than admit a problem and make some sort of plan to improve it they lie and spin and lie some more. Just notice how they call a massive (30%) increase in calls a 'pressure' rather than a bloody disaster that we have seen coming from twelve months away - it's not like Winter just sneaks up on us does it?

And on Friday it's 'office piss-up' day.

Bloody great.

The only good thing about today has been a group of us stretcher monkeys getting a good result from a cardiac arrest. If this post reads a little weird it's because I haven't slept a wink in the last 36 hours and have just completed a 12 hour shift. At least the hallucinations haven't started yet...

I'm a bit busy at the moment (although my lurgy has mostly cleared up and my Measles blood test has come back negative, so I can return to work tomorrow starting at 'Oh my God o'clock').

I just want to draw your attention to this newstory - it's something I'm currently researching by trawling through official papers.

The short version is that in a few years time the people who 'buy' health services in the UK will be required to contract out some of the 999 A&E ambulance services to private companies.

I happen to think that this is a bad idea, and the BBC has picked up on it recently as well.

More on this once I've had a chance to research it properly.

BBC Links here.

Utterly unconnected, but there is an interesting Guardian article about how the government might deal with internet and social networking communication during a terrorist attack - I'd hope that this has no basis in fact as to do what is suggested would (a) probably not work (b) cause more problems than it solves and (c) almost certainly be illegal.