I was met by a friend and as I walked into the corridor I saw my patient sitting on the stair-lift. She saw me, turned and smiled at me.

Eighty three years old, Jamaican born and already dressed ready to go to hospital.

"Hello there, what seems to be the problem?", I asked, kneeling down so I wouldn't be towering over her.

"I fell down the stairs", she replied.

She'd fallen down all fourteen stairs, tumbling backwards from the top. She's landed at the bottom and had hit herself on the stairlift parked there. She couldn't remember the fall and the only obvious injury was a swelling to her leg. Nothing obviously broken but she'd probably have a few bruises the next day.

I take these sorts of things seriously, it's a long fall and with old bones there is a real chance of serious injury. While she looked fine, I wasn't going to take any chances, so I popped a hard collar around her neck to help protect it if she had injured it.

It was only after we had safely secured her in the ambulance that she told me that the fall had happened more than twenty-four hours ago, and that it was only because she couldn't walk on her painful leg that she had called us there.

She hadn't been able to walk because of the pain, yet had only now considered it serious to call an ambulance. I also suspect that it was only because her friend had visited and 'bullied' her into calling an ambulance that we were there now.

Thankfully, after a load of x-rays at the hospital, it turned out that the pain in her leg was from a large bruise and that she hadn't seriously injured herself.

This is why any suggestion for a charge for an ambulance, or for a charge for an inappropriate call won't work. The people who need us will struggle on because they 'don't want to be a burden', while the people who think they are 'entitled' to our free taxi every time they get a sniffle will continue to use us as such - if only because any 'fine' won't be paid, or the person will be so poor they won't be eligible for being charged.

I can't begin to count the number of elderly who I've picked off the floor where they have spent the whole night because, "I didn't want to bother anyone at that time of the night".

I fear that the only solution is education, maybe education administered by me and my stick o' pain.