(But before the race stuff - apparently NHS Direct are referring too many calls. What have us ambulance people been saying since it started?).

Before working for the ambulance service I was a nurse in North London. Where I worked there was a large Turkish and Greek community. But I've never met a Turkish or Greek nurse.

Where I work now there is a huge Bangladeshi population. I know of three ambulance staff on the road in my area who ethnically come from that vague area of the world. We also have one North African and one 'Black British' ambulance staff. If you were to look at the ethnic make-up of my patch of London (and here is the link for the other half of my patch) you would see that this is a massive under-representation of 'visible minority ethnic' people.

So why is this the case?

(I would suggest that they aren't daft enough to work for the NHS - but that may be seen as being snide).

I'm honestly not sure. I have a theory, and again - if people have other ideas please do educate me.

Some cultures have traditionally had to look after their own families, probably because the ambulance and health services in their country of origin are poor. I don't think that you get ambulances out in the Bangladesh countryside, so you would have to look after each other and the ambulance service isn't seen as an important job.

I have a colleague who lives in India for half of the year and she tells me that the patients relatives have to supply the food and sheets when that person enters a hospital.

Is this why certain populations in London don't consider the ambulance service for a career?

Given the amount of Eastern Europeans that are working in London at the moment it does surprise me that none of them want to join the ambulance service, although I suspect that being a plumber pays better, and why would you want to retrain when you already have a skill that transports easily.

But it goes the other way - I believe that nursing is seen as a worthwhile career in the Philippines and that is the reason there are so many nurses from there (coupled with our willingness to 'poach' nurses from other countries in a cyclical boom and bust fashion...)

The question that I haven't got an answer to is if there needs to be a change in this situation, and if so how to go about it. Beyond the normal tired 'roadshows' that tend to pop up when a committee discusses such ideas.

There is one thing that I do believe is that all the 'VME's' that work in my area in the ambulance service have been accepted by an overwhelmingly white English workforce. Of course I may be wrong, not having the same perspective that they have but I honestly think that we save our energies for our real enemies.

...Alcoholics, the government, ambulance management, St John ambulance, drug addicts, people who try to assault us, people who make frivolous claims against us, heavy people who want us to carry them downstairs, GPs, the press, nursing homes, hospitals, hospital management, hoax callers...*

This blogpost was delayed by playing Civilisation IV until the sun came up.

*Joke. Obviously. Well... mostly. I'm serious about the government.