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.

So - two weeks off work and while I should be feeling nice and relaxed, instead I have a feeling of impending doom. Lots of things on my plate and suddenly not enough time to do anything about it. Funny how everything happens along just as I'm about to go back to twelve hour shifts.

Today I'm on a training course, something to do with patient assessment I think - whatever it is it means sitting in a classroom, which means I better get in my supply of Red Bull.

Two weeks without thinking about ambulance stuff. Well almost not thinking about it.

I was staying in a hotel in Salisbury and was about to head out (at silly o'clock in the morning) to see the Summer solstice sun come up over Stonehenge. As I left my room I came across some slightly agitated young men. I walked past them and then I heard one of them mention that he had already called an ambulance.

I gritted my teeth, turned round and, explaining what my day job is, asked if I could be of any help.

Their friend had been riding motorcross and had come off his bike earlier in the day, now he'd woken up and vomited all over the bed and floor and was feeling 'grotty'. So I popped into the room and checked him out while we waited for the ambulance to arrive. My investigation suggested that he had a stomach infection rather than a head injury, so I left the patient in the more than capable hands of the ambulance FRU who turned up.

Yesterday I was woken up by a loud banging on my door - throwing on my pyjamas/lounging around clothes, I stumbled out of my bed and down the stairs to open my front door. If they had been religious people I would have taken violent offense to them disturbing my rest.

Instead it was one of my neighbours asking for help for another of my neighbours. My 'patient' had cut her varicose vein and there was a fine spray of blood spurting out from her foot. A dressing and a bit of pressure soon brought it under control and we decided to leave it at that.

Until it started bleeding again - this time she would need a bit of wound closure that I didn't have the equipment for - so I called for an ambulance and, after letting the excellent calltaker know that I was a fellow LAS person, suggested that they send down one of our ECPs as an ECP carries the sort of equipment that can close these wounds without having to take the patient to hospital.

And who should ring back but a mate of mine from my own station. He was more than a bit surprised to hear my voice on the phone.

He needed to ask permission to come out this far (as there was no-one manning the ECP post where I live), and with that permission granted he soon arrived.

Then got me to do the work while he did the paperwork...

So it all ended well, my elderly neighbour didn't need to go to hospital and everyone was happy. It's nice when a job like that comes together - even when you aren't actually working.